A study on the measurement of the nucleated red blood cell (nRBC) count based on birth weight and its correlation with perinatal prognosis in infants with very low birth weights

Abstract

PurposeThe aim of this study was conducted to investigate the mean nRBC count in very low births weight infants (VLBWIs) and to determine the usefulness of the nRBC as an independent prognostic factors of perinatal complications in VLBWIs.MethodsThis study was conducted on 112 VLBWIs who were hospitalized in the neonatal intensive care unit (NICU) of the author's hospital within the period from March 2003 to and May 2008. Based on the infants' nucleated red blood cells (nRBC) counts at birth, on the third day after birth, on the seventh day after birth, in the second week after birth, and in the fourth week after birth in the medical records, the correlation between nRBC or absolute nRBC counts with birth weight, gestational age, and other perinatal outcomes were retrospectively investigated.ResultsIn VLBWIs, their mean nRBC and absolute nRBC counts were showing a gradual decrease after birth, and they were consisteantly kept at low values since one week after and inversely proportional to the birth weights. The mean nRBC counts based on the stage after birth showed a significant correlation with perinatal death, necrotizing enterocolitis, and severe intraventricular hemorrhage.ConclusionThe increase in the nRBC count showed a significant correlation with having a severe intraventricular hemorrhage, necrotizing enterocolitis, and perinatal death in VLBWIs. If an increase or no decrease in the nRBC count after birth is observed, newborn-infant care precautions should be required.

Nucleated red blood cells as marker for an increased risk of unfavorable outcome and mortality in very low birth weight infants

“…Notably, a persisting elevation of NRBC counts after 24 h of life in VLBW infants with intrauterine growth restriction indicates unfavorable outcome. Consistent with our findings, a close correlation between birth weight and NRBC count was previously reported [7,9,17]. Kil et al [7] investigated in 112 VLBW infants the association of the relative NRBC count per 100 white blood cells determined by microscopic counting of the blood smear at different postnatal timepoints and the perinatal prognosis.…”

“…Consistent with our findings, a close correlation between birth weight and NRBC count was previously reported [7,9,17]. Kil et al [7] investigated in 112 VLBW infants the association of the relative NRBC count per 100 white blood cells determined by microscopic counting of the blood smear at different postnatal timepoints and the perinatal prognosis. In that study, the NRBC count at birth and on the 7th day correlated with perinatal death in a multiple linear regression model classifying the infants according to their birth weight [7].…”

“…Kil et al [7] investigated in 112 VLBW infants the association of the relative NRBC count per 100 white blood cells determined by microscopic counting of the blood smear at different postnatal timepoints and the perinatal prognosis. In that study, the NRBC count at birth and on the 7th day correlated with perinatal death in a multiple linear regression model classifying the infants according to their birth weight [7]. Bashat et al [9] analyzed the NRBC count by means of manual microscopy in 172 growth restricted preterm infants and found that a persistent relative NRBC count of N70 per 100 white blood cells at day 4 predicted major morbidity with a sensitivity of 82%.…”

“…Thus, hypoxia is supposed to be one major factor increasing the number of circulating NRBC due to either stimulated erythropoiesis [4][5][6] or release from storage pools [2]. Several studies have demonstrated an association between elevated NRBC and poor perinatal outcome, including necrotizing enterocolitis [7], severe intraventricular hemorrhage (IVH) [7][8][9], cerebral palsy (CP), periventricular leukomalacia (PVL) [10,11], or death [7]. There are conflicting results regarding the association of the NRBC count at birth and the incidence or retinopathy of prematurity (ROP).…”

Association of nucleated red blood cells with mortality in critically ill dogs

“…In human beings, the occurrence of NRBCs in peripheral blood has been noted with a variety of illnesses, for example, burn injuries, liver and kidney failure, multiorgan dysfunction syndrome, hypoxaemia, and perinatal asphyxia, as well as after cardiothoracic surgery and stem cell transplantation (Boning and others 2001, Stachon and others 2001, 2006a, Lehnhardt and others 2005, Lesesve and others 2006, Boskabadi and others 2010, Kil and others 2011). …”