Nucleated Red Blood Cells Count as a prognostic biomarker in predicting the complications of asphyxia in neonates

Introduction: Nucleated red blood cells (NRBC) count in umbilical cord of newborns is recently been suggested as a sign of birth asphyxia. The present study was conducted to explore the value of NRBC count in prognosis of asphyxiated neonates.Methods: sixty three neonates with asphyxia were followed up for two years. Maternal and neonatal information was recorded follow by clinical and laboratory evaluation. NRBC level was determined per 100 white blood cells (WBC). After discharge, follow-up of asphyxiated infants was performed using Denver II test at 6, 12, 18 and 24 months. Neonates were divided into two groups, with favorable and unfavorable outcome based on developmental delay or death. Result: we observed that NRBC count with more than 11 per 100 WBC, had sensitivity of 85% and specificity of 90% in predicting complications of asphyxia, while in absolute NRBC count with more than 1554, the sensitivity and specificity were 85% and of 87%, respectively. Combination of NRBC + HIE (hypoxic ischemic encephalopathy) grade had a high predictive power for determining the prognosis of asphyxia in neonates.Conclusion: we demonstrate that NRBC/100 WBC and absolute NRCB count can be used as prognostic marker for neonatal asphyxia, which in combination with the severity of asphyxia could indicate high infant mortality, and complications of asphyxia. Further studies in a larger and multi center setting trail are warranted to investigate the value of NRBC and HIE in asphyxiated term infants.

کلیدواژه ها:

Hypoxic Ischemic Encephalopathy ، Nucleated Red Blood Cells ، Asphyxia ، Neonates