Correlation of nucleated red blood cell count with neonatal intensive care unit admission


  • Sambedna . Department of Obstetrics and Gynaecology, AIIMS, Patna, Bihar, India
  • Amit Kumar Department of Pediatric Surgery, AIIMS, Patna, Bihar, India
  • Rita Chakore Department of Obstetrics and Gynaecology, PMCH, Patna, Bihar, India



Fetal heart rate, Neonatal intensive care unit, Umbilical cord blood, White blood cell2349-3291.ijcp20204551


Background: Perinatal asphyxia should be diagnosed, when baby goes on to develop hypoxic ischemic encephalopathy which has shown to be much more reliable indicator of long term handicap than any other perinatal markers like non reassuring FHR, Apgar score, meconium stained amniotic fluid and blood acid base status of fetus. Since NRBC is related to hematopoietic response to hypoxia it predicts the chance of neurological sequelae and NICU admission. The aim of our study to analyze the significant relationship of NRBC count and NICU admission.

Methods: This was a retrospective comparative study conducted in department of OBG, Patna medical college and Hospital between December 2013 to November 2015 in tertiary care health centre. Umbilical cord blood samples were collected from 100 newborns with asphyxia at birth out of which 56 were admitted in NICU taken as study group and rest 44 asphyxiated babies were not admitted in NICU were taken as control group. NRBC per 100 WBC was counted in Cord blood sample from all babies.

Results: This shows that average count of NRBC/100 WBC in the study with NICU admission was 27.37+7.25. Average count in the study group with no NICU admission was 23.93+6.04. The difference was statistically significant (p<0.05).

Conclusions: This study concludes that NRBC count correlate well with fetal asphyxia and finally NICU admission. Early detection leads to decrease neurological morbidity and mortality among survivors.

Author Biographies

Amit Kumar, Department of Pediatric Surgery, AIIMS, Patna, Bihar, India


Rita Chakore, Department of Obstetrics and Gynaecology, PMCH, Patna, Bihar, India

Professor, obstetrics and gynaecology



Palmer L, Blair E, Patterson B, Burton P. Antenatalantecedents of moderate and severe cerebral palsy. Pediatr Epidemiol. 1995;95:171-84.

Jaisle F. Zur Ätiologie der Zerebralparese. Z Geburtshilfe Neonatol. 1996;200:169-75.

Dürig P, Schneider H. Diagnostik und möglichkeitender prävention der geburtsassoziierten Asphyxie als ursache der hypoxisch ischämischen enzephalopathie. Gynakologe. 1999;31:680-9.

Blair E, Stanley FJ. When can cerebral palsy be prevented? The generation of causal hypotheses by multivariate analysis of a case-controlled study. Paediatr Perinat Epidemiol. 1993;7:272-301.

Merenstein GB, Blackmon LR, Kushner J. Nucleated red-cells in the newborn. The Lancet. 1970;295 (7659):1293-4.

Anderson GW. Studies on the nucleated red blood cell count in the chorionic capillaries and the cord blood of various ages of pregnancy. Am J Obstet Gynecol. 1941;42:1-14.

Hanlon-Lundberg KM, Kirby RS, Gandhi S, Broekhuizen FF. Nucleated red blood cells in cord blood of singleton term neonates. Am J Obstet Gynecol 1997;176:1149-54.

Axt R, Ertan AK, Hendrik HJ, Wrobel M, Mink D, Schmidt W. Nucleated red blood cells in cord bloodof singleton term and post-term neonates. J Perinat Med. 1999;27:376-81.

Ertan AK, Jost W, Hendrik J, Lauer S, Uhrmacher S, Schmidt W. Perinatal events and neuromotoricdevelopment of children with zero flow in the fetal vessels during the last trimester. In: Cosmi EV, DiRenzo GC eds. Second World congress of perinatal medicine. Bologna, Italy: Monduzzi Editore Spa;1993:1049-52.

Maier RF, Böhme K, Dudenhausen JW, Obladen M. Cord blood erythropoietin in relation to different markers of fetal hypoxia. Obstet Gynecol. 1993;81: 575-80.

Korst LM, Phelan JP, Ahn MO, Martin GI. Nucleatedred blood cells: an update on the marker for fetal asphyxia. Am J Obstet Gynecol. 1996;175: 843-6.

Phelan JP, Korst LM, Ahn MO, Martin GI. Neonatalnucleated red blood cell and lymphocyte counts infetal brain injury. Obstet Gynecol. 1998;91: 485-9.

Widness JA, Teramo KA, Clemons GK. Temporalresponse of immunoreactive erythropoietin to acutehypoxemia in fetal sheep. Pediatr Res. 1986;20:15-9.

Snijders RJM, Abbas A, Melby O, Ireland RM, Nicolaides KH. Fetal plasma erythropoietin concentrationin severe growth retardation. Am J Obstet Gynecol. 1993;168:615-9.

Groenenberg IA, Baerts W, Hop WC, Wladimiroff JW. Relationship between fetal cardiac and extracardiac Doppler flow velocity and neonatal outcome inintrauterine growth retardation. Early Hum Dev.1991;26:185-92.

Bernstein PS, Minior VK, Divon MY. Neonatal nucleatedred blood cell counts in small for gestational age fetuses with abnormal umbilical artery Dopplerstudies. Am J Obstet Gynecol. 1997;177:1079-84.

Baschat AA, Gembruch U, Reiss I, Gortner L, Harmann CR, Weiner CP. Neonatal nucleated red blood cell counts in growth-restricted fetuses, relationship to arterial and venous Doppler studies. Am J Obstet Gynecol. 1999;181:190-5.

Papa D, Jayanthi S. Primary choriocarcinoma of fallopian tube. J Obstet Gynecol.2008;58(6):529-30.

Hanlon-Lundberg KM, Kirby RS, Gandhi S, Broekhuizen FF. Nucleated red blood cells in cord blood of singleton term neonates. Am J Obstet Gynecol. 1997;176(6):1149-54.

Buonocore G, Vezzosi P, Perrone S, Gioia D and Bracci R. Erythroblast count in newborn infants in relation to different markers of fetal hypoxia. Pediatr Res. 1996;40:522.






Original Research Articles