A study of nucleated red blood cell count as a marker of severity of hypoxic ischemic encephalopathy

Dipankar Bala, Sankar Das


Background: Encephalopathy is a term used to describe central nervous system dysfunction. Neonatal encephalopathy associated with perinatal asphyxia is called hypoxic ischemic encephalopathy. Birth asphyxia and subsequently developing Hypoxic Ischemic Encephalopathy (HIE) is one of the major causes of perinatal mortality and morbidity especially in developing countries like India. The present study will be carried out to analyse nucleated red blood cell count and to find out a relationship between this and severity of HIE.  

Methods: A prospective (case control) study was undertaken between august 2011 and October 2013 in the neonatal intensive care unit, the study population was consisted of 50 full term infants with asphyxia (group-1) and 50 healthy new-born (group-2).  

Results: The average absolute nRBC count (nRBC/mm3) for the control group was 38.6/mm3. It is 426.55/mm3 in the first period with SD of 203.99 & a SEM of 48.08 (in HIE Gr-I). It increases with time in 2nd period and again decreases in the third time period. However the average value is always higher than the control group (p<0.001). In case of HIE Gr-II the average nRBC count is 498.45 with SD of 214.72 and a SEM of 56.8 whereas these are 412.43, SD of 202.54 & SEM of 48.32 in case of HIE Gr-III. So there is a positive correlation between the absolute number of nRBC count and HIE, but there is no linear correlation between the nRBC count and the severity of HIE.

Conclusions: Nucleated red blood cell count (nRBC) count increases in all grades of HIE, but there is no linear correlation between nRBC count and the severity of HIE.  


Hypoxic ischemic encephalopathy (HIE), Nucleated red blood cell (nRBC)

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