Nucleated red blood cells count as a prognostic biomarker in predicting the complications of asphyxia in neonates

Figures & data

Table 1. Comparison of the average of maternal and neonatal clinical parameters in asphyxiated *neonates with favorable and unfavorable outcomes.

Variables	Asphyxiated neonates with favorable outcomes 32 cases(%50.8)	Asphyxiated neonates with unfavorable outcomes 31 cases(%49.2))	*Significance level (T-Test)
First-minute Apgar score	1.39 ± 4.37	1.62 ± 4.35	0.790
Fifth-minute Apgar score	2.04 ± 6.78	1.98 ± 5.74	0.051
White blood cell(WBC)	6.01 ± 14.38	19.13 ± 27.41	0.001
NRBC/100 WBC	7.59 ± 4.51	86.05 ± 57.79	0.004
Absolute nrbc count	697.28 ± 519.30	25674.98 ± 18557.80	0.001
Duration of hospital stay (days)	3.16 ± 6.07	8.96 ± 8.76	0.153
Age of mother (years)	8.53 ± 25.70	5.34 ± 25.73	0.987
BUN (mg/dl)	6.86 ± 18.91	9.51 ± 25.83	0.095
Creatinine (mg/dl)	0.21 ± 0.52	0.41 ± 0.92	0.005
Sodium (mg/dl)	4.78 ± 14.00	5.61 ± 138.64	0.497
Potassium (mg/dl)	1.18 ± 5.15	1.38 ± 5.54	0.431
FBS (mg/dl)	21.86 ± 93.94	19.15 ± 88.00	0.663
First-hour pH	0.07 ± 7.22	0.150 ± 7.10	0.001
HCO3a (mmol/L)	6.47 ± 15.88	5.16 ± 13.07	0.242
PCO2a (mmHg)	8.86 ± 422.57	11.12 ± 43.55	0.836

Table 2. Comparison of some maternal and neonatal variables in the two groups of asphyxiated neonates with favorable and unfavorable outcomes.

Groups variables	Asphyxiated neonates with favorable outcomes 32 cases (%50.8)	Asphyxiated neonates with unfavorable outcomes 31 cases (%49.2)	P* (Chi-square test)
HIE grades
No HIE	9 (29.03)	1 (3.22)
HIE Grade I	19 (61.29)	1 (3.22)
HIE Grade II	3 (9.67)	11 (35.48)	<0.0001
HIE Grade III	0 (0)	18 (58.06)
Sex
Male	10 (35.71)	20 (66.67)	0.018
Female	18 (64.28)	10 (33.33)
Type of delivery
Natural Cesarean	10 (31.25)	14 (45.16)	0.256
section	22 (68.75)	17 (54.84)
Mechanical ventilators
Used	27 (87.10)	9 (31.03)	<0.0001
Not used	4 (12.90)	20 (68.97)

Table 3. Comparison of the combination of indicators that predict the risk of unfavorable prognosis.

Diagnostic methods	-2 log likehood	Cox & Snell R Square	Nagelkerke R Square	Hosmer and Lemeshow Test	Predicted percentage correct
NRBC + absolute NRBC count + HIE grade + PH1	8.199	0.707	0.943	0.915	94.2
NRBC + absolute NRBC count + PH1	25.310	0.596	0.795	0.925	88.7
NRBC + absolute NRBC count	33.191	0.549	0.734	0.866	0.86
NRBC + HIE grade	10.953	0.694	0.927	1.000	94.6
Absolute NRBC count + HIE grade	12.611	0.685	0.915	1.000	92.9
Absolute NRBC count + HIE grade + PH1	10.889	0.691	0.922	1.000	92.3

Figure 1. ROC curve for comparison of sensitivity and specificity of NRBC and absolute NRBC count in asphyxiated neonates, to determine the prognosis in 24 months.

Table 4. Comparison of the final outcomes for neonates at different NRBC and absolute NRBC count levels.

Variables	Asphyxiated neonates with favorable outcomes (32 cases, 50%) number (percent)	Asphyxiated neonates with unfavorable outcomes (31 cases, 50%) number (percent)	P (Chi-square test)
Level NRBC/100WBC			0.000
0–11	28 (90.32)	4 (15.38)
11.1–321	3 (9.68)	22 (84.62)
Level absolute NRBC count			0.000
0–1554	27 (87.10)	4 (15.38)
1555–8000	4 (12.90)	22 (84.62)