Cord Blood Nucleated Red Blood Cell Count as a Marker of Perinatal Asphyxia and its Severity among Term Neonates: A Comparative Cross Sectional Study

Abstract

Introduction: Introduction: Perinatal asphyxia remains one of the leading causes of neonatal morbidity, neurological disability and mortality  worldwide. The present study was conducted to evaluate the association 
between cord blood nucleated red blood cell (NRBC) count per 100 white  blood cells (WBCs) in healthy and asphyxiated neonates and to determine  its relationship with the severity of asphyxia and short-term neonatal 
outcomes.

Materials and Methods: This study was a comparative cross-sectional study conducted in Department of Pediatrics at National Medical College. The study was carried out over a period of one year, from October 2022 to  September 2023. Immediately after delivery, 2 ml of umbilical cord blood was collected in EDTA vial and sent for nucleated red blood cell (NRBC) analysis.

Results: The mean NRBCs per 100 WBCs in the case and control groups was 20±12.176 and 4.70±3.344,respectively, which was statistically significant (p<0.001). The mean NRBCs per 100 WBCs in HIE 1, 2 and 3 was 13.30±4.923,  21.54±13.90 and 28±11.22, respectively, which was statistically significant (p=0.028), implying a positive correlationbetween NRBC count and HIE stages.

Conclusion: Cord blood NRBC count is significantly elevated in asphyxiated neonates and correlates with the severity of hypoxic-ischemic encephalopathy.