Advertisement!
Author Information Pack
Editorial Board
Submit article
Special Issue
Editor's selection process
Join as Reviewer/Editor
List of Reviewer
Indexing Information
Most popular articles
Purchase Single Articles
Archive
Free Online Access
Current Issue
Recommend this journal to your library
Advertiser
Accepted Articles
Search Articles
Email Alerts
FAQ
Contact Us
Indian Journal of Maternal-Fetal & Neonatal Medicine

Volume  4, Issue 2, Jul-Dec 2017, Pages 133-138
 

Original Article

Nucleated Red Blood cells as a Marker of Perinatal Hypoxic Events in Neonates

Deena Thomas1, Jacob Abraham2, Jiju Joseph3

1Senior Resident 2Professor and Chief 3Assistant Professor, Unit of Neonatology, Department of Paediatrics, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala 689101, India

Choose an option to locate / access this Article:
90 days Access
Check if you have access through your login credentials.        PDF      |
|

Open Access: View PDF

DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.4217.6

Abstract

Objectives: To correlate nucleated RBC count per 100 WBC (nRBC/ 100WBC) within first 24 hours of birth in term and near term neonates with perinatal hypoxic events and to correlate increased nRBC/100WBC with adverse prognostic outcome in neonates. Design: Prospective comparative study. Setting: Level III neonatal intensive care unit (NICU) of tertiary care hospital in southern India. Participants: 128 neonates e— 34 weeks of gestation admitted in NICU over 10 months period. Methods: Neonates were grouped into twoperinatal hypoxic and controls. Details regarding birth weight, gestational age, maternal age, relevant antenatal history and mode of delivery was obtained. Examination included Apgar score at birth and assessment for need for any respiratory support. Blood gas estimation from umbilical cord blood at birth and peripheral smear examination for nRBC/100WBC within first 24 hours of birth was done. Morbidity in form of duration of NICU stay was evaluated. Result: Among 128 babies, 46 had perinatal hypoxia while 82 acted as control. Mean nRBCs/100WBC among the cases was 15.54±63.66 whereas that in control was 3.74±5.21. Among the term babies, mean nRBC/100 WBC was significantly higher in those with perinatal hypoxia (17.28±69.09) as compared to controls (3.15±4.418). Statistically significant association was observed between mean nRBC/100WBC and gestational age at birth, requirement of resuscitation at birth and duration of NICU stay. On constructing receiver operating characteristics curve, among term babies for nRBC/100 WBC of >2, sensitivity and specificity was 66.67% and 64.15% respectively, with a positive and negative predictive value of 57.77% and 72.34% respectively. The specificity increased to 95% when a cut off > 13 nRBC/100 WBC was used. Conclusion: Among term babies, mean nRBC/100WBC was significantly higher in those with perinatal hypoxia as compared to controls. Hence raised nRBC/100WBC at Day 1 of life in term babies can be taken as surrogate marker of perinatal hypoxic event provided confounding factors have been eliminated. Higher mean nRBC/100WBC on Day 1 of life can be used as a predictor of morbidity and hence longer duration of NICU stay.

Keywords: Erythroblasts; Hypoxia; Intensive Care Units; Neonatal; Gestational Age. 


Corresponding Author : Deena Thomas Senior Resident, Department of Paediatrics, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla., Kerala 689101, India