Comparison of cord blood nucleated red blood cells with clinical markers of perinatal asphyxia

Background: The fetal compensatory response to hypoxia is erythropoiesis resulting in influx of immature red blood cells into fetal circulation, level of which may be correlated with perinatal asphyxia. Nucleated red blood cells (NRBCs) are commonly seen in the circulation of newborns. The number of NRBCs per 100 white blood cells (WBCs) varies and it is usually less than 10. >10 NRBCs are usually seen in cases of prematurity, Rh sensitization, maternal diabetes mellitus and intra uterine growth retardation. Asphyxia is also said to cause an increase in the nucleated RBC’S in the newborns. Methods: Study included NRBCs/100 white blood cells in umbilical venous sample and it's comparson with clinical markers of perinatal outcome. A prospective study was done between November 2020 to 2022. Subjects included singleton term babies. Results: The presence of thick Meconium stained amniotic fluid, non-reassuring FHR pattern and low Apgar at 1 minute was associated with higher number of NRBC and was statistically significant. Conclusions: Nucleated RBCs in cord blood of the newborns are the best correlators of perinatal outcome compared to the clinical markers.