Umbilical cord blood nucleated red cell count as a marker of perinatal asphyxia

Authors

  • Manisha Chavan Department of Paediatrics, Ashwini Rural Medical College, Hospital and Research Centre, Kumbhari, Solapur, Maharashtra, India
  • Pratibha M. Patil Department of Paediatrics, Ashwini Rural Medical College, Hospital and Research Centre, Kumbhari, Solapur, Maharashtra, India
  • Vijay Bagali Pediatrics consultant, Ashwini Rural Medical College, Hospital and Research Centre, Kumbhari, Solapur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20181000

Keywords:

Cord blood nucleated red blood cell, Hypoxic ischaemic encephalopathy, Perinatal asphyxia

Abstract

Background: Nucleated RBCs are a common observation in the circulating blood of newborn. Number of nRBC in cord blood and perinatal asphyxia shows good correlation. Perinatal asphyxia ranks as the second most important cause of neonatal death after infections accounting for about 30% mortality worldwide. Objective of the present study was designed to find the relation between umbilical cord blood nRBC count and perinatal asphyxia.

Methods: The present one-year prospective case control study was carried out. A total of 100 babies divided into two groups of 50 each as cases and controls. Term babies with perinatal asphyxia were enrolled as cases and term babies without perinatal asphyxia born during same period were included as control.

Results: The distribution of cord blood pH in cases showed maximum babies (80%) with pH value of <7 and 38% of the children were detected to have HIE stage II followed by 26% with stage I and 4% with stage III. At admission, 48 hours and 72 hours, significantly higher number of babies were found to have higher cord blood nRBC count (p<0.001) and the mean cord blood nRBC count was found to be significantly high at all the intervals (p <0.001). Comparison of mean cord blood nRBC count among cases in stage III was significantly high compared to stage II and I (p<0.001) at admission, 48 hours and 72 hours.

Conclusions: Cord blood nRBC can be used as surrogate marker for asphyxia. The clearance of nRBC from the circulation may be of help in prognosticating the outcome of asphyxiated babies.

 

References

Lawn JE, Manadhar A, Haws RA, Darmstadt GL. Reducing one million child deaths from birth asphyxia a survey of health systems gaps and priorities. Health Res Policy Syst. 2007;5(1):4.

Neonatal and perinatal mortality: Country, regional and global estimates. France: World Health Organization; 2006.

Hoque M, Haaq S, Islam R. Causes of neonatal admissions and deaths at a rural hospital in KwaZulu-Natal, South Africa. South African Journal of Epidemiology and Infection. 2011;26(1):26-9.

Boskabadi H, Ashrafzadeh F, Doosti H, Zakerihamidi M. Assessment of risk factors and prognosis in asphyxiated infants. Iran J Pediatr. 2015;25:e2006.

Report of the National Perinatal Database (National Neonatology Forum, India) 2000.

Cloherty JP. Eichenwald EC, Stark AR. Nanual of neonatal care 6th Ed. Philadelphia: Lippincott Williams and Wilkins; 2008.

Gomella TL, Cunningham DM, Eyal FG, Zenk KE. Neonatology: Management, Procedures, on-call problems, diseases and drugs. 5th Ed. USA: McGraw Hill; 2003.

Buonocore G, Perrone S, Longini M, Paffetti P, Vezzosi P, Gatti MG, et al. Non-protein bound iron as early predictive marker of neonatal brain damage. Brain. 2003;126(5):1224-30.

Qureshi AG, Parvez SH. Oxidative Stress and Neurodegenerative Disorders Oxford: Elsevier; 2007.

Ferber A, Minior VK, Bornstein E, Michael Y, Divon F. Nonreassuring status is associated with elevation of nucleated red blood cell counts and interleukin-6. Am J Obstet gynecol. 2005;192(5):1427-9.

Ecker JL, Partridge JC. Prenner JL, Parer JT, Barkovich AJ. Predictors of magnetic resonance imaging abnormalities in asphyxiated neonates. Am J Obstat Gynecol. 1997;176(1):S61.

Holla RG. Preventive strategies in HIE: Current status. J Neonatal. 2006;20(2):126-33.

Nelson KB, Ellenberg JH. Apgar scores as predictors of chronic neurologic disability. Peadiatrics. 1981;68(1):36-44.

Ferns SJ, Bhat BV, Basu D. Value of nucleate red blood cells in predicting severity and outcome of perinatal asphyxia. Indian J Pathol Microbiol 2004: 47(4);503-4.

Phelan J, Kirkendall C, Korst L, Martin G. Nucleated red blood cells in fetal brain injury show a consistent relationship with the intrrapartum for patteren. Am J Obstet Gynecol. 2003;189(6):S165.

Bonebrake R, Kelly A, Fleming A. An update on nucleated red blood cells as an indicator of fetal asphyxia. Am J Obstet Gynecol. 2001;185(6):S246.

Buonocore G, Perrone S, Gilia D, Gatti MG, Massafra C, Agosta R, et al. Nucleated red blood cell count at birth as an index of perinatal brain damage Am J Obstet. 1999;181(6):1500-5.

Feber A, Fridel Z, Weissmann-Brenner A, Minior VK, Divon MY. Are elevated fetal nucleated red blood cell counts an indirect refelection of enhanced erythropoietin activity? Am J Obstett Gynecol. 2004;190(5):1473-5.

Robertson CM, Perlaman M. Follow-up of the term infant after hypoxic-ischemic encephalopathy. Paediatr Child Health. 2006;11(5):278-82.

Maulik D. Asphyxia and fetal brain damage New York: Wiley-Liss; 1998.

Goel M, Dwivedi R, Gohiya P, Hegde D. Nucleated red blood cell in cord blood as a marker of perinatal asphyxia. J Clin Neonatol. 2013;2(4):179-82.

Ruth V, Fyhrquist F, Clemons G, Raivio KO. Cord plasma vasopressin, erythropoietin and hypoxanthin as indices of asphyxia at birth. Pediatr Res. 1988;24:490-4.

Fotopoulos S, Pavlou K, Skouteli H, Papassotiriou I, Liposou N, Xanthou M. Early marker of brain damage in premature low-birth-weight neonates who suffered from perinatal asphyxia and/or infection. Biol Neonate, 2001;79:213-8.

Nerenstein GB, Blackmon LR, Kushner J. Nucleated red-cells in the newborn. Lancet. 1970;1(7659):1293-4.

Phelan JP, Ahn MO, Korst LM, Martin GI. Nucleated red blood cells: a marker for fetal asphyxia? Am J Obstet Gynecol. 1995;173:1380-4.

Korst LM, Phelan JP, Ahn MO, Martin GI. Nucleated red blood cells: An update on the marker for fetal asphyxia. Am J Obstet Gynecol. 1996;175:843-6.

Spencer MK, Khong TY, Matthews BL. MacLennan AH. Haematopoietic indicators of fetal metabolic acidosis. Aust NZ J Obstet Gynaecol. 2000;40:286-9.

Downloads

Published

2018-04-20

Issue

Section

Original Research Articles