title: Nucleated red blood cell counts and erythropoietin levels in high-risk neonates.
abstract: BACKGROUND
  The presence of increased numbers of nucleated red blood cells (NRBC) and increased levels of erythropoietin (EPO) in the circulation of neonates has been associated with states of relative hypoxia. The aim of this study is to assess the pattern of NRBC counts and EPO levels in a group of high-risk neonates under stress conditions and determine the short-term outcome for these babies by using these parameters.
  
  
  METHODS
  There were 69 high-risk neonates; 14 intrauterine growth retarded (IUGR), 25 preterm infants, 18 term infants with asphyxia and 12 infants of diabetic mothers. Control groups included healthy, term infants delivered either vaginally (n = 18) or with cesarean section (n = 19). Three blood samples were obtained from each infant within 12 h (initial), 3 days and 7 days after birth to measure NRBC counts and EPO levels. Neonatal and short-term outcomes at 3 and 6 months of age were determined.
  
  
  RESULTS
  There was no significant difference among the groups with regard to the initial serum EPO concentrations. The initial NRBC counts were significantly lower in the control groups compared with the study groups (P = 0.002). While there was no significant difference between patients with good and poor outcome in terms of EPO concentrations of initial samples, a significant difference existed in terms of NRBC counts (P = 0.038).
  
  
  CONCLUSIONS
  Both serum EPO level and NRBC count provide limited clinical benefit in the detection of pathological conditions of the neonatal period, but NRBC count determination seems to be especially helpful in predicting short-term neurodevelopmental outcome.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Trakya University, Edirne, Turkey. u_vatansever@hotmail.com
authors.forename: Ulfet
authors.initials: U
authors.lastname: Vatansever
authors.forename: Betül
authors.initials: B
authors.lastname: Acunaş
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Demir
authors.forename: Serap
authors.initials: S
authors.lastname: Karasalihoglu
authors.forename: Galip
authors.initials: G
authors.lastname: Ekuklu
authors.forename: Seralp
authors.initials: S
authors.lastname: Ener
authors.forename: Ozer
authors.initials: O
authors.lastname: Pala
mesh_terms: D000704:Analysis of Variance; D004900:Erythroblasts; D004906:Erythrocyte Count / Q000379:methods; D004921:Erythropoietin / Q000032:analysis*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000097:blood*; D007230:Infant, Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D011446:Prospective Studies
chemical_list: D004921:Erythropoietin