ASSOCIATION OF CORD BLOOD NUCLEATED RED BLOOD CELL COUNT WITH PERINATAL ASPHYXIA, IT’S SEVERITY AND IMMEDIATE OUTCOME

Objectives: Perinatal asphyxia is a major cause of neurological morbidity and mortality in India. The purpose of this study was to investigate variations in cord blood nucleated red blood cell (NRBC) with perinatal asphyxia and its relationship to both the severity and short term prognosis of asphyxia Methods: A prospective study was undertaken at SDM Hospital. A total of 150 neonates were included in the study. Levels of NRBC/100 white blood cells (WBC) and absolute NRBC counts in cord blood were compared for 75 asphyxiated (case group) and 75 normal neonates (control group). Results : The number of NRBC/100 WBC in the blood of 75 newborns each in the asphyxiated and in the control group were mean 18.56 ± 11.51 , range 7-134 NRBCs/100 WBC and mean ± standard deviation 1.79 ± 1.53, range 2-12 NRBCs/100 WBC respectively (P < 0.01). Using quartile deviation, staging of hypoxic ischemic encephalopathy (HIE) was done on basis of NRBC count and there was 85 % agreement between clinical and NRBC staging of HIE.The mean NRBC in Moderate Apgar (4-6) and severe Apgar (0-3) was 11.93 ± 3.99, 27.97 ± 12.17 respectively, Lower the Apgar score, higher was mean NRBC/100 WBC. The mean NRBC count in neurologically abnormal babies and normal babies was 23.87 ± 11.82 and 10.14 ± 2.45 respectively it was seen that the variation was statistically significant (P = 0.001). There was a significant (P < 0.01) correlation of the number of NRBC\\100 WBC with APGAR scoring, HIE staging and mortality, t = 2.258 and P = 0.0142. which is statistically significant. Conclusion: The NRBCs/100 WBCs can be used as a simple marker for the assessment of severity and early outcome of perinatal asphyxia.