Evaluation of Efficacy of Nucleated Red Blood Cell Count as a Predictor of Perinatal Asphyxia in Karnataka, South India

Background: Early diagnosis of perinatal asphyxia is very essential since it is a major cause of neurologic morbidity and mortality. The present study was undertaken to investigate the association between nucleated red blood cells count (RBCs) per 100 white blood cells (WBCs) and perinatal asphyxia with respect to its severity and prognosis. Materials and Methods: A prospective case-control study was conducted on asphyxiated and non-asphyxiated term neonates from the neonatal intensive care unit and post-natal wards of the Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka. Cord blood samples from 50 asphyxiated neonates comprising the cases and 50 healthy neonates comprising the controls constituted the material for the study. Levels of nucleated RBCs per 100 WBCs were determined from both the groups and compared. Results: No significant difference was observed between the control and the study group with respect to birth weight. The mode of delivery (normal/instrumental/cesarean) was statistically significant with a P = 0.05. The mean Apgar scores between the study group and the control group showed a P = 0.001 which was statistically significant. Nucleated RBCs (NRBCs) on 100 WBCs showed a mean value of 15.74 and standard deviation (SD) of 7.89 in the study group. The control group showed a mean value of 1.55 and SD of 0.78. The P = 0.001 was statistically significant and, therefore, a good predictor for birth asphyxia. Conclusion: Early NRBC count in cord blood is an effective, simple, cost effective baseline diagnostic tool for detecting neonatal asphyxia.