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Umbilical cord nucleated red blood cell counts: normal values and the effect of labor

Journal of Perinatology volume 26, pages 89–92 (2006)Cite this article

Abstract

Objective:

To determine the umbilical cord blood nucleated red blood cell (UC-nRBC) count in uncomplicated pregnancies delivered by elective cesarean section or delivered vaginally.

Methods:

A total of 57-term singleton pregnancies were studied: 33 with elective cesarean sections and 24 with vaginal deliveries. UC-nRBC was analyzed for its nucleated red blood cell counts. A logarithmic transformation of the data was used for statistical analysis.

Results:

The mean±standard deviation (s.d.) for nucleated red blood cell per 100 white blood cells (nRBC/100WBC) from the elective cesarean section group was 7.8±7.4. The vaginal delivery group had a mean value of 9.3±10.5, which was not significantly different. A value of 22 nRBC/100WBC defined the upper 95% confidence limit. The correlation between absolute nRBC and nRBC/100 WBC was 0.97.

Conclusion:

Although chronic hypoxia is associated with elevated nRBC, the stress of uncomplicated labor does not change the level. This adds credence to its use as a marker for hypoxia preceding labor and delivery.

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References

  1. Phelan J, Korst L, Ock Ahn M, Martin G . Neonatal nucleated red blood cell and lymphocyte counts in fetal brain injury. Obstet Gynecol 1998; 91: 485–489.

    CAS  PubMed  Google Scholar 

  2. Korst L, Phelan J, Ock Ahn M, Martin G . Nucleated red blood cells: an update on the marker for fetal asphyxia. Am J Obstet Gynecol 1996; 175: 843–848.

    Article  CAS  Google Scholar 

  3. Green DW, Mimouni F . Nucleated erythrocytes in healthy infants and in infants of diabetic mothers. J Pediatr 2001; 116: 129–131.

    Article  Google Scholar 

  4. Yeruchimovich M, Dollberg S, Green D, Mimouni F . Nucleated red blood cells in infants of smoking mothers. Obstet Gynecol 1999; 93: 403–406.

    CAS  PubMed  Google Scholar 

  5. Hanlon-Lundberg K, Kirby R, Gandhi S, Broekhuizen F . Nucleated red blood cells in cord blood of singleton term neonates. Am J Obstet Gynecol 1997; 176: 1149–1156.

    Article  Google Scholar 

  6. Baschat A, Gembruch U, Reiss I, Gortner L, Harman CR, Weiner CP . Neonatal nucleated red blood cell counts in growth-restricted fetuses: relationship to arterial and venous Doppler studies. Am J Obstet Gynecol 1999; 181: 190–195.

    Article  CAS  Google Scholar 

  7. Ferber A, Grassi A, Akyol D, O’Reilly-Green C, Divon MY . The association of fetal heart rate patterns with nucleated red blood cell counts at birth. Am J Obstet Gynecol 2003; 188: 1228–1230.

    Article  Google Scholar 

  8. Fox H . The incidence and significance of nucleated erythrocytes in the fetal vessels of the mature human placenta. J Obstet Gynaecol Br Commonw 1967; 74: 40–43.

    Article  CAS  Google Scholar 

  9. Leikin E, Garry D, Visintainer P, Verma U, Tejani N . Correlation of neonatal nucleated red blood cell counts in preterm infants with histologic chorioamnionitis. Am J Obstet Gynecol 1997; 177: 27–30.

    Article  CAS  Google Scholar 

  10. Widness JA, Teramo KA, Clemons GK, Garcia JF, Cavalieri RL, Piasecki GJ et al. Temporal response of immunoreactive erythropoietin to acute hypoxemia in fetal sheep. Pediatr Res 1986; 20: 15–19.

    Article  CAS  Google Scholar 

  11. Georgieff MD, Schmidt RL, Mills MM, Radmer WJ, Widness JA . Fetal iron and cytochrome status after intrauterine hypoxemia and erythropoietin administration. Am J Physiol 1992; 262: R485–R491.

    CAS  PubMed  Google Scholar 

  12. Blackwell SC, Hallak M, Hotra JW, Refuerzo J, Hassan SS, Sokol RJ, Sorokin Y . Timing of fetal nucleated red blood cell count elevation in response to acute hypoxia. Biol Neonate 2004; 85: 217–220.

    Article  Google Scholar 

  13. Naeye R, Localio R . Determining the time before birth when ischemia and hypoxemia initiated cerebral palsy. Obstet Gynecol 1995; 86: 713–719.

    Article  CAS  Google Scholar 

  14. Phelan J, Ock Ahn M, Korst L, Martin G . Nucleated red blood cells: a marker for fetal asphyxia? Am J Obstet Gynecol 1995; 173: 1380–1384.

    Article  CAS  Google Scholar 

  15. Hermansen MC . Nucleated red blood cells in the fetus and newborn. Arch Dis Child Fetal Neonatal Ed 2001; 84: F211–F2115.

    Article  CAS  Google Scholar 

  16. Widness JA, Clemons GK, Garcia JF, Oh W, Schwartz R . Increased immunoreactive erythropoietin in cord serum after labor. Am J Obstet Gynecol 1984; 148: 194–197.

    Article  CAS  Google Scholar 

  17. Fox H . The incidence and significance of nucleated erythrocytes in the fetal vessels of the mature human placenta. J Obstet Gynaecol Br Commonw 1967; 74: 40–43.

    Article  CAS  Google Scholar 

  18. McCarthy J, Capullari T, Spellacy W . The correlation between automated hematology and manually read smears for the determination of nucleated red blood cells in umbilical cord blood. J Matern Fetal Neonatal Med 2005; 17: 199–201.

    Article  Google Scholar 

  19. Saracoglu F, Sahin I, Eser E et al. Nucleated red blood cells as a marker in acute and chronic fetal asphyxia. In J Gynecology and Obstetrics 2000; 71: 113–118.

    CAS  Google Scholar 

  20. Ghosh B, Mittal S, Kumar S, Dadhwal V . Prediction of perinatal asphyxia with nucleated red blood cells in cord blood of newborns. In J Gynecology and Obstetrics 2003; 81: 267–271.

    CAS  Google Scholar 

  21. Axt R, Ertan K, Hendrik J, Wrobel M et al. Nucleated red blood cells in cord blood of singleton term and post-term neonates. J Perinat Med 1999; 27: 376–381.

    CAS  PubMed  Google Scholar 

  22. Rumke CL . Statistical reflections on finding atypical cells. Blood Cells 1985; 11: 141–144.

    CAS  PubMed  Google Scholar 

  23. Sheffer-Mimouni G, Mimouni F, Lubetzky R et al. Labor does not affect the neonatal absolute nucleated red blood cell count. Am J Perinatology 2003; 20: 367–371.

    Article  Google Scholar 

  24. Thilaganathan B, Athanasiou S, Ozmen S, Creighton S, Watson NR, Nicolaides KH . Umbilical cord blood erythroblasts counts as an index of intrauterine hypoxia. Arch Dis Child Fetal Neonal Ed 1994; 70: F192–F194.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology of the University of South Florida College of Medicine, Tampa, FL, USA

    J M McCarthy & W N Spellacy

  2. Department of Pathology of Tampa General Hospital, The University of South Florida, Tampa, FL, USA

    T Capullari

  3. Department of Epidemiology and Biostatistics, The University of South Florida, Tampa, FL, USA

    Z Thompson & Y Zhu

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  1. J M McCarthy
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  2. T Capullari
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Correspondence to J M McCarthy.

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McCarthy, J., Capullari, T., Thompson, Z. et al. Umbilical cord nucleated red blood cell counts: normal values and the effect of labor. J Perinatol 26, 89–92 (2006). https://doi.org/10.1038/sj.jp.7211437

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