Relationship of Nucleated Red Blood Cells with Severity of Perinatal Asphyxia and Its Short-Term Outcome


  • Mehwish Iqbal Resident, Neonatology department, Recep Tiyyap Erdogan Hospital Muzaffargarh


Background: Globally, perinatal hypoxia is a severe issue that frequently results in infant mortality and long-term morbidity. The premature erythrocytes known as erythroblast, or nucleated red blood cells (NRBCs), are frequently observed in newborns' blood. Their presence in peripheral blood is connected to the hypoxic growing environment of the foetus, therefor NRBCs may the convenient marker for determining the severity and early development of neonatal birth asphyxia.

Objective: To compare the nucleated red blood cell (NRBC) counts of healthy and asphyxiated newborns as a key clinical indicator of the severity of birth asphyxia and short-term outcome.

Setting: Current study was conducted at paediatric department of

Study design: Case control study

Study duration: Six months from June 2020 to November 2020

Methods:  Total 112 term newborns including 56 as cases (with birth asphyxia) and 56 as controls (normal babies) aged <24 hours were included. After taking informed consent blood samples were taken immediately after birth for the measurement of NRBC count. All the enrolled cases were admitted in NICU and observed for the severity of birth asphyxia and mortality. The correlation of cord blood NRBC count with severity of birth asphyxia. NRBC count and outcome were analyzed statistically.

Results: The overall average age of the neonates was 14.18+2.66 hours. Boys were more compared to girls. Mean NRBC count was (14.0+18.22) in cases, which was significantly higher compared to controls (2.10+3.93) p-0.002. less than 2 fits/day were observed in 8 cases and >2 fits/days were observed in 6 cases of birth asphyxia. There was a positive coloration of NRBC count with haemoglobin, creatinine level, ALT, and AST. Average NRBC count was significantly high in cases of cardiomegaly, those having ventilation need and respiratory distress syndrome (RDS) (p-<0.05).

Conclusions: The NRBC was observed to be a non-invasive, simple prognostic marker for neonatal asphyxia, may indicate substantial infant mortality and asphyxia-related complications. Mean NRBC was observed significantly higher in cases compared to controls.

Keywords: Birth asphyxia, NRBCs, correlation, mortality.





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