THE CORRELATION BETWEEN PARAMETERS OF UMBILICAL CORD BLOOD COUNT AND BRAIN DAMAGE IN NEWBORNS WITH PERINATAL ASPHYXIA

Abstract

Perinatal asphyxia is a major cause of acute pediatric mortality and long-term neurologic sequelae amongs survivors.Aims: were to evaluate parameters of umbilical cord blood count in asphyxiated and healthy newborns and to correlate this to the brain damage. Methods: We included 70 alive-born newborns from single pregnancies, gestational age 24.-42. weeks, with perinatal asphyxia (case group) and 40 healthy newborns (control group) in period between July 01, 2011 and May 31, 2013. Levels of umbilical cord blood count were compared between groups and related to the severity of brain damage in asphyxiated newborns. Results: Brain damage occurred in 44/70 (62,9%) asphyxiated newborns; 25 (56,8%) had hypoxic-ischemic encephalopathy (HIE) Grade I; 12 (27,3%) had Grade II; and 7 (15,9%) had Grade HIE III. Case group had significant higher values of leukocytes, neutrophils, nonsegmented neutrophils and lymphocyte counts, but lower red blood parameters and platelet counts, comparing to controls. We found good positive correlation between leucocyte (rho=0,674;p<0,0001), lymphocyte count (rho=0,572;p<0,0001), good negative correlation between platelet count (rho= -0,715; p<0,0001) and the grade of brain damage. Total red cell count (rho= -0,437; p=0,0002) and hemoglobin values (rho= p=0,0003) had border negative relationship with the severity of brain damage in newborns with perinatal asphyxia. Conclusion: Various hematologic parameters in umbilical cord blood were changed during asphyxia. Some of them had good correlation with brain damage and in combination with clinical signs we may be able to predict the severity of the asphyxial insult and decide on the relevant management of newborns.