Nucleated red blood cells: An update on the marker for fetal asphyxia

Korst, Lisa M.; Phelan, Jeffrey P.; Ahn, Myoung Ock; Martin, Gilbert I.

doi:10.1016/s0002-9378(96)80010-x

Cited by 136 publications

(93 citation statements)

References 7 publications

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“…Elevated NRBC counts are a marker of fetal hypoxia and may predict poor outcome after hypoxic-ischemic encephalopathy, 22,23 although other studies have not found a correlation with brain injury. 24 There have not been any specific studies on the predictive value of NRBC counts in patients with CHD.…”

Section: Discussionmentioning

confidence: 97%

Neurologic events in neonates treated surgically for congenital heart disease

et al. 2006

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Objective: The incidence of acute neurologic events prior to discharge in neonates with congenital heart disease (CHD) was determined and peri-operative characteristics predictive of a neurologic event were identified.Study design: A retrospective chart review over 1 year was conducted of infants <1 month of age with a diagnosis of CHD. Outcomes were measured by the occurrence of an acute neurologic event defined as electroencephalogram (EEG)-proven seizure activity, significant hypertonia or hypotonia, or choreoathetosis prior to hospital discharge.Stepwise logistic regression identified variables most likely to be associated with an acute neurologic event.Results: Surgical intervention occurred in 95 infants who were admitted with a diagnosis of CHD. The survival rate was 92%. Of the survivors, 16 (17%) had an acute neurologic event, with 19% of events occurring preoperatively. Factors associated with neurologic events included an elevated nucleated red blood cell (NRBC) count, an abnormal preoperative brain imaging study, and a 5-min Apgar score <7 (P<0.05). Conclusions:Neonates with CHD have a significant risk of neurologic events. Preoperative brain imaging, the 5-min Apgar score, and initial serum NRBC counts may identify infants at highest risk for central nervous system injury.

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Section: Discussionmentioning

confidence: 97%

Neurologic events in neonates treated surgically for congenital heart disease

et al. 2006

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“…In an attempt to control for the various variables known to affect neonatal nucleated RBC counts, we excluded from the study infants in both groups who were born to women with gestational or insulin-dependent diabetes 15 ; pregnancy-induced hypertension 16 ; intrauterine growth retardation (defined as a birth weight below the 10th percentile using the Lubechenco curves 12,17 ); placental abruption or placenta previa 18 ; any maternal heart, kidney, lung, or other chronic condition; drug, tobacco, or alcohol abuse 19 ; perinatal infections (eg, maternal fever, maternal leukocytosis [white blood cells (WBCs) Ͼ 15.0 ϫ 10 3 /mm 3 ], clinical signs of chorioamnionitis such as fever and abdominal tenderness) 20 ; any abnormality in electronic intrapartum monitoring 18 ; or infants with low Apgar scores (Ͻ6 at 1 or 5 minutes). 21 We also excluded infants with perinatal blood loss, hemolysis (blood-group incompatibility with positive Coombs test or hematocrit of Ͻ45%), 22 or chromosomal anomalies.…”

Section: Patientsmentioning

confidence: 99%

Nucleated Red Blood Cells in Preterm Infants With Retinopathy of Prematurity

et al. 2005

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ABSTRACT. Objective. The aim of this retrospective study was to examine hematologic indices of potential intrauterine hypoxia, including circulating nucleated red blood cells, lymphocytes, and platelets in preterm infants who developed retinopathy of prematurity (ROP) compared with suitable controls. We hypothesized that higher neonatal absolute nucleated red blood cell (ANRBC) and lymphocyte counts and lower platelets would be found in infants who developed ROP, compared with control infants.Methods. Each of 23 infants with ROP was pair matched for gestational age and Apgar scores with a control without ROP. Criteria for exclusion in both groups included factors that may influence the ANRBCs at birth. Venous ANRBC counts were obtained within 1 hour of life. Statistical analyses used paired t tests, a paired Wilcoxon test, and backward stepwise-regression analysis.Results. Groups did not differ in birth weight, gestational age, Apgar scores, or hematocrit, white blood cell, or platelets counts. The ANRBC counts at birth were significantly higher in infants who developed ROP than in controls.Conclusions. Infants who develop ROP have higher ANRBC counts at birth than matched controls. We suggest that increased fetal erythropoiesis exists in preterm infants who later on will develop ROP. If correct, our interpretation supports the theory that long-lasting fetal hypoxia and/or ischemia may play a role in the pathogenesis of ROP. ABBREVIATIONS. ROP, retinopathy of prematurity; RBC, red blood cell; WBC, white blood cell; ANRBC, absolute nucleated red blood cell; IVH, intraventricular hemorrhage.

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“…1 It has been suggested that the presence of elevated NRBC in the umbilical cord blood is a sign of fetal hypoxia. [1][2][3][4][5][6][7][8][9][10][11][12] It is affected by factors such as prematurity, preeclampsia, fetal growth restriction, isoimmunization, maternal tobacco use, maternal diabetes mellitus and chorioamnionitis.…”

Section: Introductionmentioning

confidence: 99%

Outcome in the small for gestational age neonates in their early neonatal period in relation with the cord blood nucleated RBC’s

Reddy

Chittam

Kumar

et al. 2017

Int J Contemp Pediatr

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Background: NRBCs are physiologically found only in the peripheral blood of the fetus and neonates. Under all other conditions, NRBC is an indicator of pathology, either increase in erythroid activity or damage to the bone marrow has been suggested that the presence of elevated NRBC in the umbilical cord blood is a sign of fetal hypoxia.1-12. Elevated NRBC is a sign of fetal hypoxia in newborns of mothers with preeclampsia even with well controlled hypertension.Methods: The study period is 1 year from November 2015 to October 2016 on Term SGA babies delivered in Navodaya Medical College Hospital and Research Centre. Inclusion criteria all term SGA and healthy term AGA Newborns. Exclusion criteria were mothers with the following condition: maternal diabetes mellitus, hypertension, preeclampsia, chorioamnionitis and babies with the following conditions meconium stained amniotic fluid, congenital anomalies, twin-to-twin transfusion, severe anemia, cyanotic heart disease.Results: The mean gestational age among control and study group was 18.96 and 19.08 respectively. Low APGAR score (≤5) was seen in 3 cases in the study group. No newborn in control group had low APGAR. Out of 50 babies included in this study,24 babies were delivered by LSCS and 26 babies by normal vaginal delivery. the NRBC count was found to be significantly higher in the SGA babies group as compared to the AGA group and this was statistically significant [p,0.005].Conclusions: My study showed that NRBC count was higher in SGA babies than term AGA babies but there was no correlation of NRBC count with the outcome in SGA babies.

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Nucleated red blood cells: An update on the marker for fetal asphyxia

Cited by 136 publications

References 7 publications

Neurologic events in neonates treated surgically for congenital heart disease

Neurologic events in neonates treated surgically for congenital heart disease

Nucleated Red Blood Cells in Preterm Infants With Retinopathy of Prematurity

Outcome in the small for gestational age neonates in their early neonatal period in relation with the cord blood nucleated RBC’s

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