Significance of Maternal and Cord Blood Nucleated Red Blood Cell Count in Pregnancies Complicated by Preeclampsia

Abstract

Objectives. To evaluate the effect of preeclampsia on the cord blood and maternal NRBC count and to correlate NRBC count and neonatal outcome in preeclampsia and control groups. Study Design. This is a prospective case control observational study. Patients and Methods. Maternal and cord blood NRBC counts were studied in 50 preeclamptic women and 50 healthy pregnant women. Using automated cell counter total leucocyte count was obtained and peripheral smear was prepared to obtain NRBC count. Corrected WBC count and NRBC count/100 leucocytes in maternal venous blood and in cord blood were compared between the 2 groups. Results. No significant differences were found in corrected WBC count in maternal and cord blood in cases and controls. Significant differences were found in mean cord blood NRBC count in preeclampsia and control groups (40.0 ± 85.1 and 5.9 ± 6.3, P = 0.006). The mean maternal NRBC count in two groups was 2.4 ± 9.0 and 0.8 ± 1.5, respectively (P = 0.214). Cord blood NRBC count cut off value ≤13 could rule out adverse neonatal outcome with a sensitivity of 63% and specificity of 89%. Conclusion. Cord blood NRBC are significantly raised in preeclampsia. Neonates with elevated cord blood NRBC counts are more likely to have IUGR, low birth weight, neonatal ICU admission, respiratory distress syndrome, and assisted ventilation. Below the count of 13/100 leucocytes, adverse neonatal outcome is quite less likely.

Effect of maternal preeclampsia on neonatal red cell parameters

“…15 Similarly, a study done by Hebbar S et al in the year 2014 also showed lower birth weights in neonates from preeclamptic mothers(2171±805.3 grams) compared to those from normal healthy pregnancies (2976.1± 473.3grams) which was also statistically significant(p<0.001). 16 In the present study, the Total Red Blood Cell count of neonates in case group (4.797±0.40 X10 6 /µL) was higher than the Total Red Blood Cell count of neonates in the control group (4.666±0.42 X10 6 /µL). The difference of means of the two groups was statistically not significant (p value>0.05).…”

Expression levels of ABCG2 on cord red blood cells and study of fetal anemia associated with anti‐Jra

“…S1‐a [available as supporting information in the online version of this paper]: r = −0.3649, p = 0.003). However, since cord RBCs contain erythroid precursors, reticulocytes, and RBCs and ABCG2 is expressed early in RBC maturation, we correct the ABCG2 expression levels by square of FSC, which reflects a surface area of the particle. The difference of ABCG2 expression among the gestational ages was not detected after compensation (Fig.…”

Study of cord blood nucleated RBC’s as a marker for fetal asphyxia

“…8 They are primarily produced in the fetal bone marrow in response to erythropoietin and are stored in the marrow as precursors mature erythrocytes Studies have shown decreasing nRBCs as the gestational age increases, except that post-term infants have higher counts than term infants. 9 Tissue hypoxia results in increased levels of erythropoietin, which in turn leads to stimulation of erythropoiesis and increased numbers of circulating nRBCs.…”