Prediction of perinatal asphyxia with nucleated red blood cells in cord blood of newborns.
OBJECTIVE
To determine normal level of nucleated red blood cells (NRBC) per 100 white blood cells (WBC) in cord blood of term non-asphyxiated newborns and to investigate variations in NRBC counts in perinatal asphyxia.


METHODS
A total of 75 cases were studied. Levels of NRBC per 100 WBC in umbilical venous blood were compared between 26 asphyxiated newborns (group I) and 49 non-asphyxiated newborns (group II). Correlation with neonatal outcome was also evaluated.


RESULTS
The mean (+/-S.D.) NRBC per 100 WBC level in umbilical blood of newborns in group I was 16.5+/-6.4, range 3-25; whereas that in group II was 8.6+/-7.01, range 1-26. This difference was statistically significant (P<0.001). A statistically significant negative correlation existed between NRBC level and markers of acute intrapartum asphyxia, Apgar score and umbilical arterial pH (r=-0.50, P<0.001 and r=-0.48, P<0.001, respectively). Positive correlation was demonstrated with evidence of chronic antepartum asphyxia, presence of pregnancy induced hypertension and intrauterine growth restriction (r=2.66, P=0.02). A high NRBC count in umbilical blood correlated with poor early neonatal outcome.


CONCLUSIONS
The level of NRBC per 100 WBC correlates both with acute as well as chronic antepartum asphyxia. Further, it can be used as a reliable index of early neonatal outcome.
Ghosh
B
B
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Mittal
S
S
Kumar
S
S
Dadhwal
V
V
D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000097:blood* / Q000503:physiopathology; D016022:Case-Control Studies; D004900:Erythroblasts; D004906:Erythrocyte Count; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors; D014469:Umbilical Arteries / Q000503:physiopathology