Predictive value of nucleated red blood cells in early life for neurological prognosis in asphyxiated preterm infants

Objective To explore the prognostic significance of nucleated red blood cell (NRBC) in asphyxiated premature infants within one year after birth, and to provide evidence for clinical decision of cerebral protection in asphyxiated premature infants. Methods Fifty asphyxiated premature infants hospitalized in the Department of Neonatology, Affiliated Hospital of Hebei University from January 2021 to December 2022 were enrolled as observation group and 20 non-asphyxiated premature infants as control group. NRBC data, brain MRI and amplitude-integrated electroencephalography were compared between the two groups. Developmental quotient (DQ) of two groups of children were evaluated after correction at 42 days and 3, 6, 9, and 12 months of age, and correlation between NRBC% and DQ at various time points was analyzed. Results The NRBC% in the early postnatal period of the observation group was higher than that of the control group (P＜0.05) . The incidence of abnormal amplitude-integrated electroencephalogram results in the observation group was higher than that of the control group (P＜0.05) . The incidence of abnormal cranial magnetic resonance imaging findings in the observation group was higher than that of the control group (P＜0.05) . After correction at 42 days, 3, 6, 9, and 12 months of age, the scores of the Developmental Behavior Checklist for children in the observation group were all lower than those in the control group (P＜0.05) . And there were time, inter group, and interactive effects (P＜0.05) . Scatter plots were drawn for the NRBC% of the observation group and the developmental quotient (DQ) of neurological assessments at different corrected ages. It was found that there was a negative correlation between NRBC and the DQ evaluation results at each corrected age (P＜0.05). Conclusion It can be used as an early index to predict the nervous system retardation in asphyxiated premature infants under corrected 1 year of age, and to provide a basis for early intervention to improve the outcome of the nervous system.