Nucleated red blood cells as an early marker of intraventricular haemorrhage in newborn infants

Abstract

Abstract Introduction: The aim of the paper was to evaluate the usability of nucleated blood cells count in newborn infants in the first 12 hours after their birth as an early marker of intraventricular haemorrhage. Material and methods: The retrospective research included 210 newborns (both born at term and prematurely), delivered at the Department of Clinical Sciences of Perinatology of the I Chair of Gynecology and Obstetrics of the Medical University in Lodz, Poland from 1 January 2003 to 31 December 2006. During the first 12 hours after the birth, the abovementioned infants were diagnosed with nucleated blood cells in their blood count. The correlation between the number of nucleated blood cells and the occurrence of intraventricular haemorrhage has been investigated. Intraventicular haemorrhage was diagnosed with the use of transfontanel ultrasonography between the third and the seventh day of life. The increased number of erythroblasts was established to be on the level above 20 nucleated blood cells/100 white blood. The material was subject to statistical analysis which included the use of a Spearman’s rank correlation coefficient, a chi-square test, and a Mann-Whitney test. The statistically significant level adopted equaled p <0.05. Results: Out of 210 newborns included in the survey, among 71 (33.81%) intraventricular haemorrhage were diagnosed in the first week of their life. The I and II grade haemorrhage occurred in 61 newborns, which equals 85.92%, and the III or IV grade haemorrhage occurred in 10 patients (14.08%). In case of 50 newborns with IVH (70.42%) the number of nucleated blood cells exceeded 20/100 white blood cells. The average level of erythroblast for newborns with IVH equaled 87.46 (146.49), and in the group without IVH 38.86 (7.82). In order to examine the relation between the number of nucleated blood cells and the intraventricular haemorrhage a Spearman’s rank correlation coefficient was used, as well as a chi-square test and a Mann-Whitney test. On their basis it was concluded that there is a statistically significant relation between the level of erythroblast and the occurrence of intraventricular haemorrhage p=0,0048. Conclusions: The evaluation of the number of nucleated red blood cells in newborn infants can be an early, noninvasive marker of the intraventricular haemorrhage in newborns.