Study of perinatal asphyxia and its outcome concerning nucleated RBC count in venous blood of term neonates

Abstract

Introduction: Perinatal asphyxia is a serious problem globally and is one of the common causes ofneonatal mortality. Worldwide each year four million infants suffer from birth asphyxia. Of these onemillion die and an equal number develop serious sequelae. Perinatal asphyxia ranks as the secondmost important cause of neonatal death after infections accounting for about 23% of mortalityworldwide. Aim & objective: To establish the level of nucleated red blood cells as an indicator ofpoor immediate outcome in perinatal asphyxia. Method: It was a case-control study done in thedepartment of pediatrics, S C B Medical College & S V P PG I P, Cuttack. Observation: The NRBCcount was significantly higher in neonates with adverse outcomes than in those with favourableoutcomes (p-value <0.001). NRBC count cut-off of >27/100 WBC had a sensitivity of 75% andspecificity of 95.2% in predicting adverse outcome defined as death, hemiplegia, hypertonia orsignificant hypotonia, unreliable sucking and seizures resistant to Phenobarbital. Conclusion:Nucleated red blood cell count can be used as a surrogate marker for birth asphyxia. It has asignificant negative correlation with Apgar score at one minute and Apgar score at 5minutes &significant positive correlation with severity of hypoxic ischemic-encephalopathy, time is taken forrecovery of neurological impairment following birth asphyxia and duration of NICU stay.