Cord Blood Nucleated Red Blood Cell Level:
 Is It A Predictive Marker For Neonatal Jaundice?

Background: Neonatal jaundice is a common and generally benign condition. However, permanent neurological damage occurs due to bilirubin encephalopathy in severe hyperbilirubinemia. The most important method to prevent bilirubin encephalopathy is to predict the babies who will develop severe neonatal hyperbilirubinemia.

Objective: The aim of this study was to evaluate if the cord blood nucleated red blood cell (nRBC) levels can predict the development of hyperbilirubinemia in healthy neonates.

Methods: Umbilical venous blood samples were obtained from immediately after delivery and were analyzed using an automated hematology analyzer to determine the total white blood cell (WBC) count. The nRBC count was described per 100 WBC by the Wright stain of the blood smear, and also absolute nRBC count per cubic millimeter of cord blood was calculated. The study group were classified: Group 1, healthy newborns with serum total bilirubin (STB) levels

Results: Overall, 149 eligible newborn infants were enrolled into the study. Significant statistical differences between the groups were found for nRBC and absolute nRBC counts (p = 0.01 and 0.02, respectively). The nRBC count and absolute nRBC counts were higher in the group 3 infants.

Conclusion: We concluded that increased nRBC counts in cord blood may be indicative of increased levels of bilirubin in the newborn. This may be due to the toxic effect of bilirubin or increased bilirubin production to reduce oxidative stress. Evaluation of nRBC in cord blood is a non-invasive, easy and inexpensive method. Therefore, it can be used as a new marker to guide the physicians for following the infants to reduce the anxieties of the families and to prevent performing unnecessary tests.