Abstract
To determine the umbilical cord blood nucleated red blood cell (UC-nRBC) count in uncomplicated pregnancies delivered by elective cesarean section or delivered vaginally. A total of 57-term singleton pregnancies were studied: 33 with elective cesarean sections and 24 with vaginal deliveries. UC-nRBC was analyzed for its nucleated red blood cell counts. A logarithmic transformation of the data was used for statistical analysis. The mean+/-standard deviation (s.d.) for nucleated red blood cell per 100 white blood cells (nRBC/100WBC) from the elective cesarean section group was 7.8+/-7.4. The vaginal delivery group had a mean value of 9.3+/-10.5, which was not significantly different. A value of 22 nRBC/100WBC defined the upper 95% confidence limit. The correlation between absolute nRBC and nRBC/100 WBC was 0.97. Although chronic hypoxia is associated with elevated nRBC, the stress of uncomplicated labor does not change the level. This adds credence to its use as a marker for hypoxia preceding labor and delivery.
Highlights
The determination of whether a hypoxic insult to a newborn infant was sustained in the antepartum or intrapartum time period is of crucial value to obstetrics research
Conclusion: chronic hypoxia is associated with elevated nRBC, the stress of uncomplicated labor does not change the level
It has been suggested that the presence of elevated nucleated red blood cells in umbilical cord blood (UC-nRBC) is a sign of chronic fetal hypoxia.[1,2]
Summary
The determination of whether a hypoxic insult to a newborn infant was sustained in the antepartum or intrapartum time period is of crucial value to obstetrics research. It has been suggested that the presence of elevated nucleated red blood cells in umbilical cord blood (UC-nRBC) is a sign of chronic fetal hypoxia.[1,2] Studies have established that in term infants, this index may be affected by factors such as maternal diabetes mellitus,[3,4,5] fetal growth restriction,[6,7] RH isoimmunization,[8] maternal tobacco use,[4] and chorioamnionitis.[9]. It has been suggested that acute hypoxia in humans can be associated with elevated nucleated red blood cells.[13,14,15] In humans, labor has been associated with elevated umbilical cord erythropoietin levels.[16] Increased nRBC have been found in placentas in association with cases of acute hypoxia.[17]
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