Could Nucleated Red Blood Cell Count Be Useful in the Diagnosis of Moderate to Severe Hypoxic-ischemic Encephalopathy?

Abstract

Objective: We determined the diagnostic role of nucleated red blood cell (NRBC) count in neonates with moderate to severe hypoxic-ischemic encephalopathy (HIE). Methods: Newborns treated for moderate-to-severe HIE in a neonatal intensive care unit between January 2020 and January 2021 were included in the study. The study was designed as a retrospective cohort. NRBC counts, blood gas, and demographic and clinical characteristics were recorded before and after treatment in newborns with HIE who received therapeutic hypothermia treatment and in healthy newborns as a control group. The results of the healthy control and moderate-severe HIE groups were compared. Results: A total of 90 infants, 45 in the control group and 45 in the HIE group, were included in the study. The groups were similar in terms of gestational week, birth weight, type of delivery and gender (p>0.05). The NRBC count before hypothermia was significantly higher in the HIE group than in the control group (p=0.001). After hypothermia treatment, NRBC count decreased significantly in the HIE group (p=0.001), and the results were similar in the control group. According to the results of the ROC analysis, the area under the curve was determined as 0.983. Maximum sensitivity and specificity and the threshold value for NRBC (x103/mm3) in predicting HIE was found to be 0.63 with 95% confidence intervals. Conclusion: NRBC count, which is an easy and a fast test, can be used in clinical practice to support the diagnosis of moderate-severe HIE.

Keywords

• asphyxia
• hypoxic ischemic encephalopathy
• newborn
• nucleated red blood cell