Background: Variable responses to hypothermic neuroprotection are related to the clinical heterogeneity of encephalopathic babies; hence better disease stratification may facilitate the development of individualized neuroprotective therapies. Objectives: We examined if whole blood gene expression analysis can identify specific transcriptome profiles in neonatal encephalopathy. Material and Methods: We performed next-generation sequencing on whole blood RNA from 12 babies with neonatal encephalopathy and 6 time-matched healthy term babies. Genes significantly differentially expressed between encephalopathic and control babies were identified. This set of genes was then compared to the host RNA response in septic neonates and subjected to pathway analysis. Results: We identified 950 statistically significant genes discriminating perfectly between healthy controls and neonatal encephalopathy. The major pathways in neonatal encephalopathy were axonal guidance signaling (p = 0.0009), granulocyte adhesion and diapedesis (p = 0.003), IL-12 signaling and production in macrophages (p = 0.003), and hypoxia-inducible factor 1α signaling (p = 0.004). There were only 137 genes in common between neonatal encephalopathy and bacterial sepsis sets. Conclusion: Babies with neonatal encephalopathy have striking differences in gene expression profiles compared with healthy control and septic babies. Gene expression profiles may be useful for disease stratification and for developing personalized neuroprotective therapies.

Complete blood counts (CBC) of umbilical cord blood from 123 healthy term newborns were simultaneously performed with two different cytometers using laser as a light source. Medians (95% range) were: WBC 14.2 (7.8–24.3) × 10⁹/l, platelets 265 (174–363) × 10⁹/l, Hb 15.7 (12.5–18.2) g/dl, RBC 4.6 (3.9–5.5) × 10¹²/l, MCV 106 (95–113) fl, PCV 0.49 (0.40–0.56), and MCH 33.8 (30.3–36.4) pg. Reticulocytes were 149 (95–212) × 10⁹/l or 3.3 (2.0–4.7)%; erythroblasts 5 (0–24) per 100 WBC or 0.53 (0.00–3.20) × 10⁹/l. The counters agreed well except for MCHC. WBC counts showed the smallest difference irrespective of erythroblast number; platelets showed the largest difference. The lower limit for normal Hb should be fixed at 12.5 g/dl for the adequate diagnosis of anaemia from cord blood of term newborns.

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Introduction and Background Late preterm infants (LPI) are born at a gestational age between 34 weeks and 36 weeks and 6 days. They have higher morbidity and mortality than term infants due to their relative physiologic and metabolic immaturity. Method Infants born between July 2008 and July 2010 are identified using NICU and Labor and delivery registry of King Faisal Specialist Hospital-Jeddah. The deliveries are around 1100 births per year. The pertinent data of all mothers and neonates delivered at KFSH&RC-J abstracted from medical records. Singleton vs. twin or triplet 59.7% vs. 28.7% or 11.6%; the gravida the maternal age and gravida showed no difference; morbidity in LPI, respiratory distress syndrome 92/230 (40%) hyperbilirubineamia required treatment 13/230 (5.7%), apnea 11/230 (4.8%), sepsis 21/230(9.5%), feeding problems 23/230 (10%), hospital readmission 8/230 (3.5%). Admission to NICU was 116/229 (50%). Conclusion Our result is very comparable with previous other studies, however the mortality rate in our series is negligible, perhaps related to our aggressive management and early admission to NICU for 48 hours observation.

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