European Journal of Molecular & Clinical Medicine

Background: 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
count per 100 white blood cells in cord blood of term newborns with
perinatal asphyxia and its relationship to both the severity and short term prognosis of
asphyxia.
Methods:A cross-sectional comparative study was undertaken between June 2016 and May 2017 in the Neonatal Intensive Care Unit of CSI holsworth memorial hospital and Cheluvamba Hospital, Mysuru. A total of 120  newborns completed the study, out of which  60 asphyxiated term newborns  (case group)  and 60 normal term neonates (control group) Immediately after birth, umbilical cord blood was  collected and a thin blood smear slide was prepared which was  stained with Leishman stain for NRBC count. The NRBC count of the case group and the control group were compared. The results were analyzed statistically.
Results:The mean (± SD) NRBC count in normal term newborns born of normal vaginal delivery was 5.3 ± 3.25 NRBC/100WBC (range 0-16). The mean NRBC count in asphyxiated  babies was 23.65±12.9 NRBC/100WBC, ranging from 8 to 63. Hence, the NRBC  count was significantly higher in the asphyxiated group compared to normal babies  (p-value < 0.001).The NRBC count cut-off  of  >10/100WBC has sensitivity of 96.7% , specificity of 95%,positive predictive value of 95% and negative predicting value of 96.6% in predicting asphyxia defined as Apgar at 1 minute ≤ 6.
Conclusions:Nucleated red blood cell  cord blood collected is a simple marker for assessment of severity and early outcomes in perinatal asphyxia. Early NRBC count in cord blood is a simple & cost effective strong marker for  birth asphyxia.