Nucleated red blood cells count as a prognostic biomarker in predicting the complications of asphyxia in neonates.
OBJECTIVE
Nucleated-red-blood-cells (NRBC) count in umbilical cord of newborns is been suggested as a sign of birth asphyxia. The present study was conducted to explore the value of NRBC count in prognosis of asphyxiated neonates.


METHODS
Sixty-three neonates with asphyxia were followed up for two years. Maternal and neonatal information was recorded follow by clinical and laboratory evaluation. NRBC-level was determined per 100 white-blood-cells (WBC). After discharge, follow-up of asphyxiated infants was performed using Denver II test at 6, 12, 18 and 24 months. Neonates were divided into two groups, with favorable and unfavorable outcome based on developmental delay or death.


RESULTS
We observed that NRBC count with more than 11 per 100 WBC, had sensitivity of 85% and specificity of 90% in predicting complications of asphyxia, while in absolute NRBC count with more than 1554, the sensitivity and specificity were 85% and of 87%, respectively. Combination of NRBC + HIE (hypoxic ischemic encephalopathy) grade had a high-predictive power for determining the prognosis of asphyxia in neonates.


CONCLUSIONS
We demonstrate that NRBC/100 WBC and absolute NRCB count can be used as prognostic marker for neonatal asphyxia, which in combination with the severity of asphyxia could indicate high infant mortality, and complications of asphyxia. Further studies in a larger and multi center setting trail are warranted to investigate the value of NRBC and HIE in asphyxiate term infants.
a Department of Pediatrics , Mashhad University of Medical Sciences , Mashhad , Iran.
Hassan
H
Boskabadi
b Department of Midwifery , Faculty of Medicine, Islamic Azad University of Tonekabon , Tonekabon , Iran.
Maryam
M
Zakerihamidi
c Hematology and blood banking Department, Ghaem hospital, Mashhad University of Medical Sciences , Mashhad , Iran.
Mohammad Hadi
MH
Sadeghian
d Department of Modern Sciences and Technologies , School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran.
Amir
A
Avan
d Department of Modern Sciences and Technologies , School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran.|e Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran , and.
Majid
M
Ghayour-Mobarhan
f Division of Medical Education , Brighton and Sussex Medical School , Brighton , UK.
Gordon A
GA
Ferns
D000293:Adolescent; D000328:Adult; D001238:Asphyxia Neonatorum / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002658:Developmental Disabilities / Q000097:blood / Q000209:etiology*; D004900:Erythroblasts; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D011379:Prognosis; D055815:Young Adult
D015415:Biomarkers
Asphyxia; hypoxic ischemic encephalopathy; neonates; nucleated red blood cells