Correlation of nucleated red blood cells with severity of birth asphyxia and its immediate outcome in term newborns

Abstract

Background: The severity of birth asphyxia can be predicted by APGAR score and umbilical cord blood pH. The Nucleated Red Blood Cells (NRBCs) in the cord blood at birth emerged as a newer predictor of birth asphyxia. This study was conducted to find the correlation of cord blood Nucleated Red Blood Cell (NRBC) count with the severity of birth asphyxia and its immediate outcome in term newborns. Methods: An observational hospital based prospective case control study was conducted at inborn NICU, Bal Chikitsalya, RNT Medical College, Udaipur (Raj.) INDIA from March 2015 to September 2015. Total 100 term newborns including 50 as cases (with birth asphyxia) and 50 as controls (normal babies) were enrolled for the study. The cord blood was collected immediately after birth for the measurement of NRBC/100 WBC count and pH value. All the enrolled cases were admitted in NICU and observed for the immediate neurological outcome. The correlation of cord blood NRBC count with APGAR scores, cord blood pH and outcome was analysed statistically. Results: The mean NRBC (NRBC/100 WBC) count was 17.82±19.55 (range from 0-102) in case group and 1.42±3.26 (range from 0 to 18) in control group (p < 0.001). A statistically significant negative correlation of NRBC count was found with severity of birth asphyxia. Conclusions: A simple, cheap, rapid and non-invasive test of NRBC count from umbilical cord blood correlates well with APGAR score and cord blood pH to predict the severity of birth asphyxia and immediate outcome.