Document Detail

Neonatal nucleated red blood cell and lymphocyte counts in fetal brain injury.
MedLine Citation:
PMID:  9540927     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether neonatal lymphocyte or nucleated red blood cell (RBC) counts can be used to date fetal neurologic injury. METHODS: Singleton, term infants with hypoxic-ischemic encephalopathy, permanent neurologic impairment, and sufficient laboratory data were divided into two groups: infants with preadmission injury, manifested by a nonreactive fetal heart rate (FHR) pattern from admission until delivery; and infants with acute injury, manifested by a normal FHR pattern followed by a sudden prolonged FHR deceleration. Lymphocyte and nucleated RBC values were compared with published high normal counts for normal neonates: 8000 lymphocytes/mm3 and 2000 nucleated RBCs/mm3. RESULTS: The study population consisted of 101 neonates. In the first hours of life, lymphocyte counts were elevated among injured newborns, and then the counts rapidly normalized. Brain-injured neonates were 25 times more likely to have a lymphocyte count greater than 8000 than were normal neonates (54 [62%] of 87 versus 6 [7%] of 84; odds ratio 25.5; 95% confidence interval 8.8, 80.1; P < .001). The mean lymphocyte count tended to be higher in the preadmission-injury group than in the acute-injury group. In comparison, nucleated RBC values were not correlated as strongly with neonatal hours of life; nucleated RBC counts tended to be higher and persist longer among neonates with preadmission injury than among those with acute injury. CONCLUSION: Compared with normal levels, both lymphocyte and nucleated RBC counts were elevated among neonates with fetal asphyxial injury. Both counts appear to be more elevated and to remain elevated longer in newborns with preadmission injury than in infants with acute injury. However, the rapid normalization of lymphocyte counts in these injured neonates limits the clinical usefulness of these counts after the first several hours of life.
J P Phelan; L M Korst; M O Ahn; G I Martin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  91     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-04-29     Completed Date:  1998-04-29     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  485-9     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Pomona Valley Hospital Medical Center, California, USA.
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MeSH Terms
Brain Injuries / blood*
Brain Ischemia / blood*
Erythrocyte Count
Fetal Blood*
Fetal Diseases / blood*
Hypoxia, Brain / blood*
Infant, Newborn
Lymphocyte Count
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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