Nucleated red blood cell count at birth as an index of perinatal brain damage

OBJECTIVE: The prognostic value of the nucleated red blood cell count at bi rth with respect to perinatal brain damage and neonatal outcome was assesse d in infants at high risk of having neurologic damage. STUDY DESIGN: The nucleated red blood cell count at birth, pulsed Doppler u ltrasonography in the cerebral arteries, cranial fontanelle sonograms, and neurodevelopmental status were evaluated in 337 newborn infants. RESULTS The nucleated red blood cell count at birth was significantly highe r (1) in neonates with abnormal Doppler ultrasonographic parameters for the cerebral arteries at 48 to 72 hours after birth than in healthy neonates, (2) in 6-month-old infants with sequelae of hypoxic-ischemic encephalopathy than in healthy infants, and (3) in 3-year-old children with abnormal deve lopmental status than in those with no abnormalities at follow-up. Signific ant correlations were observed between the nucleated red blood cell count a nd gestational age, Apgar score at 1 and 5 minutes, pH, base deficit, fract ion of inspired oxygen, blood oxygen content, and birth weight. CONCLUSIONS: The nucleated red blood cell count at birth not only reflects a response of the infant to perinatal hypoxia but is also a reliable index of perinatal brain damage.