Relationship of Nucleated Red Blood Cells with Severity of Perinatal Asphyxia and its Short-Term Outcome

Objective: To compare the nucleated red blood cell (NRBC) counts of healthy and asphyxiated newborns as a key clinical indicator of the severity of birth asphyxia and short-term outcome. Methodology: This case control study was conducted at the paediatric department of neonatology of Recep Tiyyap Erdogan Hospital Muzaffargarh from June 2020 to November 2020. Study A total of 112 term newborns, including 56 cases (with birth asphyxia) and 56 controls (normal babies) aged <24 hours, were included. After obtaining informed consent, blood samples were taken immediately after birth for the measurement of the NRBC count. All the enrolled cases were admitted to the NICU as per indication and observed for the severity of birth asphyxia. The relationship between the cord blood NRBC count and the severity of birth asphyxia was assessed. All the information was recorded using a self-structured study proforma, and SPSS version 26 was used for the purpose of data analysis. Results: The overall average age of the neonates was 6.18+2.66 hours. Mean age, birth weight, and gestational age were statistically insignificant in accordance to cases and controls. Males were in the majority (75.0%), and females were 25.0% of the case group. The mean NRBCs in the cases were 16.62 + 17.10, which was significantly higher than the controls at 1.69 + 2.42 (p- 0.0001). The neonatal NRBs average was statistically insignificant according to gender in both cases and controls, while it was significantly associated with the severity of perinatal hypoxia (p 0.0001). The average NRBC count was also significantly higher in cases of cardiomegaly, those having ventilation needs and respiratory distress. Conclusion: The mean NRBC was observed to be significantly higher in cases compared to controls. The NRBC was considered to be a non-invasive, simple prognostic marker for neonatal asphyxia, may indicate substantial severity of perinatal hypoxia and its related complications.