Simple and feasible blood markers-as predictors of perinatal asphyxia

Abstract

Background: The objective of this research work was to study the hematological parameters as predictors of perinatal asphyxia and to assess their correlation with severity. Setting: Postnatal Wards, Kamla Raja Hospital and SNCU, Department of Pediatrics, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior. Design: A prospective case control study. Participants :100 cases and 100 controls enrolled based on the selection criteria, on day 1 of life.Methods: New born on day 1, who fits the selection criteria was enrolled. Birth details, relevant perinatal history, findings on physical examination and systemic signs were recorded on a predesigned proforma. Staging was done and new born classified as HIE stage I, II or III. Cord blood samples were collected and results analysed. Results: This study included 100 cases and 100 controls. Presence of maternal illness and birth history were found to have significance (p value <0.001) when compared between cases and controls. Number of nucleated RBCs/100 WBCs were found to be 6±1.93 in HIE-I; 9.5±4.8 in HIE-II and 16.45±6.6 in HIE-III as compared to 5.9±3.6 among the controls. The results are found to be significant (p value <0.001). Mean value of hemoglobin found among the controls was 16±2.5. This was 17.4±2.18 in HIE-I; 17.45±1.8 in HIE-II and 15.5±3.07 in HIE-III. The results are significant on comparison between cases and controls and among cases (p value <0.015, <0.001 respectively). Mean value of hematocrit among the controls was 49.24±7.98. This was 52.5±6.57 in HIE-I;52.56±5.46 in HIE-II and 47.6±5.8 in HIE-III. The difference was significant (p value <0.001) when comparison was done among the cases. Value of total leucocyte count (TLC) among the controls was 14.14±4.15; 14.06±6.8 in HIE-I;15.8±5.6 in HIE-II; 21.14±7.90 in HIE-III. The results were significant (p value <0.001) when comparing cases with controls and cases among themselves. There was no correlation seen with platelet count. Polychromatophilia was found significant (p value <0.001) when compared between cases and controls and among cases themselves.Conclusions:Hematological parameters are altered in perinatal asphyxia and can be used to predict the severity and outcome.