Comparison of Cord Blood pH, Haematological Parameters and APGAR Score of New-Born with Maternal and Peri-Natal Risk Factors: A Prospective Observational Study

Abstract

Introduction: Appearance, Pulse, Grimace, Activity, Respiration (APGAR) score is used worldwide to assess newborn health immediately after birth. The combination of pH analysis, haematological parameters of cord blood samples and APGAR score compared with the maternal and peri-natal risk factors will help us identify the cause of low APGAR. Aim: To compare the pH of cord blood, haematological parameters, Neutrophil-Lymphocyte Ratio (NLR) and APGAR score with high-risk maternal and peri-natal factors. Materials and Methods: This is a prospective observational study, conducted over a period of six months, at Chettinad Hospital and Research Institute, Chennai. The cord blood samples of 40 newborns (20 normal and 20 high-risk pregnancy) were collected for assessing pH and haematological parameters (complete haemogram, nucleated Red Blood Cells (RBCs), reticulocyte count). APGAR scores were obtained from clinical records. The data obtained in the study was analysed using the International Business Management (IBM) Statistical Package for Social Sciences (SPSS) statistics version 23.0. Results: The authors compared 20 cases of newborns with maternal risk-factors with 20 newborns with no risk factors, and found that low APGAR and acidic pH of cord blood, high NLR was associated with risk factors present in the ante-natal and peri-natal period. Conclusion: The present study observed that a low APGAR, low acidic pH of cord blood, high NLR was seen in mothers with adverse risk factors during pregnancy, compared to the mothers with no associated co-morbidities. Hence, the presence of riskfactors during pregnancy should warrant a close follow-up of the new-born in the immediate postpartum period.