Article

Early diagnosis of perinatal asphyxia by nucleated red blood cell count: a case-control study.

Neonatal Research Center, Department of Pediatrics, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Archives of Iranian medicine (Impact Factor: 1.22). 07/2010; 13(4):275-81.
Source: PubMed

ABSTRACT Perinatal asphyxia is a major cause of neurologic morbidity and mortality. The purpose of this study was to investigate variations in nucleated red blood cell (NRBC) count per 100 white blood cells (WBC) and absolute NRBC/mm3 in blood associated with perinatal asphyxia and its relationship to both the severity and short term prognosis of asphyxia.
A prospective (case-control) study was undertaken between October 2006 and December 2008, in the Neonatal Intensive Care Unit, Ghaem Hospital, Mashhad, Iran. A total of 91 infants completed the study. Levels of nucleated red blood cell per 100 white blood cells and absolute nucleated red blood cell counts in venous blood were compared for 42 asphyxiated (case group) and 49 normal neonates (control group). These parameters were also related to the severity of asphyxia and clinical outcome.
The NRBC/100 WBC and absolute nucleated red blood cell levels in the blood of newborns in the control group were 3.87+/-5.06 and 58.21+/-87.57/mm3, respectively; whereas the corresponding values in the cases were 18.63+/-16.63 and 634.04+/-1002/mm3, respectively (P<0.001). A statistically significant negative correlation existed between nucleated red blood cell level and indicators of the severity of perinatal asphyxia, first minute Apgar score and blood pH (P<0.001), respectively. A positive correlation was demonstrated between these parameters and severity of asphyxia, acidosis, and poor outcome (P<0.05).
The NRBC/100 WBC and/or absolute nucleated red blood cell are simple markers for assessment of severity and early outcomes of perinatal asphyxia.

2 Bookmarks
 · 
549 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives. To evaluate the effect of preeclampsia on the cord blood and maternal NRBC count and to correlate NRBC count and neonatal outcome in preeclampsia and control groups. Study Design. This is a prospective case control observational study. Patients and Methods. Maternal and cord blood NRBC counts were studied in 50 preeclamptic women and 50 healthy pregnant women. Using automated cell counter total leucocyte count was obtained and peripheral smear was prepared to obtain NRBC count. Corrected WBC count and NRBC count/100 leucocytes in maternal venous blood and in cord blood were compared between the 2 groups. Results. No significant differences were found in corrected WBC count in maternal and cord blood in cases and controls. Significant differences were found in mean cord blood NRBC count in preeclampsia and control groups (40.0 ± 85.1 and 5.9 ± 6.3, P = 0.006). The mean maternal NRBC count in two groups was 2.4 ± 9.0 and 0.8 ± 1.5, respectively (P = 0.214). Cord blood NRBC count cut off value ≤13 could rule out adverse neonatal outcome with a sensitivity of 63% and specificity of 89%. Conclusion. Cord blood NRBC are significantly raised in preeclampsia. Neonates with elevated cord blood NRBC counts are more likely to have IUGR, low birth weight, neonatal ICU admission, respiratory distress syndrome, and assisted ventilation. Below the count of 13/100 leucocytes, adverse neonatal outcome is quite less likely.
    Journal of pregnancy 01/2014; 2014:496416.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective(s): Bacterial infection contributes substantially to neonatal morbidity and mortality. Early diagnosis of neonatal sepsis is difficult because clinical signs are non-specific. We have evaluated serum IL-6, 8 and 10 as potential early diagnostic markers of neonatal infection and their relationship to mortality rate and poor prognosis. Materials and Methods : A total of 84 infants, aged ≥ 72 hr were enrolled in this prospective case-control trial. The case group (n=41) included babies with clinical and laboratory findings compatible with sepsis and/or positive blood or cerebrospinal fluid cultures. The control group (n=43) included healthy infants. IL-6, 8 and 10 were measured for all infants. Receiver-operating characteristic (ROC) curves were used for the determination of thresholds. Results : Statistically significant differences were observed between control and case groups for serum median level of IL-6, 8 and 10 (P<0.001). IL-6 cut-off values of 10.85 Pg/ml for discriminating between cases and controls and 78.2 Pg/ml for predicting mortality are suggested. IL-8 at a cut-off value of 60.05 Pg/ml was valuable for differentiation of definite versus indefinite infection. Conclusion : Evaluating the IL-6, 8 and 10 simultaneously, could improve the sensitivity and specificity of early diagnosis of the neonatal sepsis. Regarding our results, interleukin 6 had the greatest value for predicting infection and possible mortality, whereas IL-8 was valuable for diagnosing definitive infection.
    Iranian Journal of Basic Medical Science 12/2013; 16(12):1232-7. · 0.24 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The immediate and short term outcomes of term newborns with perinatal asphyxia were studied in relation to the nucleated red blood cell count at admission. The mean (SD) NRBC/100WBC (white blood cells) was significantly higher in sequelae group than normal [9.8 (98.9) vs. 2.9 (43); P = 0.001].
    Indian pediatrics 03/2014; 51(3):231-2. · 1.04 Impact Factor

Full-text (2 Sources)

Download
560 Downloads
Available from
Jun 2, 2014