A. A. Baschat, U. Gembruch, I. Reiss, L. Gortner, C. R. Harman
Neonatal nucleated red blood cell count and postpartum complications
in growth restricted fetuses
Aims: To study relationships between nucleated red
blood cell count (NRBC), persistence of NRBC count
elevation and neonatal complications in growth restricted
fetuses (IUGR).
Methods: Observational study of IUGR neonates
(birthweight < 10th percentile). NRBC's/100 WBC were
ascertained in a peripheral blood sample. Subsequent
daily samples were analyzed until NRBC's fell < 10/100
WBC. NRBC count and days of NRBC elevation were
related to complications (respiratory distress syndrome
(RDS), bronchopulmonary dysplasia (BPD), intraventricular
hemorrhage (IVH), necrotising enterocolitis
(NEC), circulatory insufficiency (CI), day 28 oxygen requirement,
mortality).
Results: 157/298 IUGR neonates (52.7%) had complications,
which were associated with a higher NRBC count
and persistence of NRBC elevation (12 vs. 189 NRBC's
and 1 vs. 4 days; p < 0.0001 respectively). This relationship
applied to each complication. Prematurity was the
main determinant of RDS, BPD and mortality, while
IVH was related to mechanical ventilation, CI to birthweight
percentile and NEC to degree of acidemia. Persistence
of NRBC count elevation was a statistical contributor
for RDS, CI and mortality, and the NRBC count
to day 28 oxygen requirement.
Conclusion: NRBC count elevation and persistent
NRBC count elevation are associated with perinatal
complications in IUGR. Wide ranges in numbers, complex
relationships between triggering factors and impacts
of other perinatal variables limit the use of NRBC
parameters as predictors of complications.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 31, 07/2003
Pages: 323 - 329
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