Labor Does Not Affect the Neonatal Absolute Nucleated Red Blood Cell Count

Galit Sheffer-Mimouni; Francis B. Mimouni; Ronit Lubetzky; Michael Kupferminc; Verda Deutsch; Shaul Dollberg

doi:10.1055/s-2003-45285

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2003; 20(7): 367-372
DOI: 10.1055/s-2003-45285

Labor Does Not Affect the Neonatal Absolute Nucleated Red Blood Cell Count

Galit Sheffer-Mimouni¹ , Francis B. Mimouni² , Ronit Lubetzky² , Michael Kupferminc¹ , Verda Deutsch³ , Shaul Dollberg²

¹Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv, Israel
²Department of Neonatology, Lis Maternity Hospital
³Department of Hematology, Tel Aviv-Sourasky Medical Center and the Sackler School of Medicine, Tel Aviv, Israel

Abstract

ABSTRACT

We investigated whether the presence or absence of physiologic labor may affect the neonatal nucleated red blood cell (RBC) count. We compared absolute nucleated RBC counts taken at approximately 6 hours of life in term infants born by elective cesarean delivery without trial of labor (n = 32) and in vaginally delivered infants (n = 28). Venous blood samples were analyzed and differential cell counts were performed manually; absolute nucleated RBC were counted and expressed as an absolute number. There were no significant differences between groups in birth weight, gestational age, maternal age, gravidity, parity, maternal analgesia during labor, 1- and 5-minute Apgar scores, and infant sex. There was a significantly higher hematocrit and RBC count in the vaginally delivered group as compared with the cesarean group. The absolute nucleated RBC, corrected leukocyte and lymphocyte, and platelet counts were strikingly similar in both groups. We conclude that labor does not affect the neonatal nucleated RBC count. This finding supports the speculation that physiologic labor does not induce a fetal hypoxemia severe or prolonged enough to produce hematological evidence of increased erythropoiesis.

KEYWORDS

Fetal hypoxia - nucleated red blood cells - labor

Volltext

Referenzen

REFERENCES

1 Hermansen M C. Nucleated red blood cells in the fetus and newborn. Arch Dis Child Fetal Neonatal Ed . 2001; 84 F211-F215
2 Lees M H, Hill J D, Ochsner III J A, Thomas C L, Novy M J. Maternal placental and myometrial blood flow of the rhesus monkey during uterine contractions. Am J Obstet Gynecol . 1971; 110 68-81
3 Widness J A, Clemons G K, Garcia J F, Oh W, Schwartz R. Increased immunoreactive erythropoietin in cord serum after labor. Am J Obstet Gynecol . 1984; 148 194-197
4 Thilaganathan B, Athanasiou S, Ozmen S, Creighton S, Watson N R, Nicolaides K H. Umbilical cord blood erythroblasts counts as an index of intrauterine hypoxia. Arch Dis Child Fetal Neonatal Ed . 1994; 70 F192-F194
5 Lubchenco L O, Hansman C, Dressler M, Boyd E. Intrauterine growth as estimated from live-born birth weight data at 24 to 42 weeks gestation. Pediatrics . 1963; 32 793-799
6 Green D W, Mimouni F. Nucleated erythrocytes in healthy infants and in infants of diabetic mothers. J Pediatr . 1990; 116 129-131
7 Yeruhimovich M, Green D W, Mimouni F B, Dollberg S. Nucleated red blood cells in healthy infants of women with gestational diabetic mothers. Obstet Gynecol . 2000; 95 84-86
8 Sinha H B, Mukherjee A K, Bala D. Cord blood haemoglobin (including foetal haemoglobin), and nucleated red cells in normal and toxaemic pregnancies. Ind Pediatr . 1972; 9 540-534
9 Korst L M, Phelan J P, Ahn M O, Martin G I. Nucleated red blood cells: an update on the marker for fetal asphyxia. Am J Obstet Gynecol . 1996; 175 843-846
10 Halmesmaki E, Teramo K A, Widness J A, Clemons G K, Ylikorkala O. Maternal alcohol abuse is associated with elevated fetal erythropoietin levels. Obstet Gynecol . 1990; 76 219-222
11 Yeruhimovich M, Dollberg S, Green D W, Mimouni F B. Nucleated red blood cell infants of smoking mothers. Obstet Gynecol . 1999; 93 403-406
12 Dollberg S, Fainaru O, Mimouni F B, Shenhav M, Lessing J B, Kupferminc M. Effect of passive smoking in pregnancy on neonatal nucleated red blood cells. Pediatrics . 2000; 106 E34
13 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
14 Hanlon-Lundberg K M, Kirby R S. Nucleated red blood cells as a marker of acidemia in term neonates. Am J Obstet Gynecol . 1999; 181 196-201
15 Dollberg S, Livny S, Mordecheyev N, Mimouni F B. Nucleated red blood cells in meconium aspiration syndrome. Obstet Gynecol . 2001; 97 593-596
16 Thomas R M, Canning C E, Cotes P M. et al . Erythropoietin and cord blood haemoglobin in the regulation of human fetal erythropoiesis. Br J Obstet Gynaecol . 1983; 90 795-800
17 Oski F A, Naiman J L. Hematologic Problems in the Newborn. 2nd ed. Philadelphia: WB Saunders; 1972
18 Widness J A, Teramo K A, Clemons G K. et al . Temporal response of immunoreactive erythropoietin to acute hypoxemia in fetal sheep. Pediatr Res . 1986; 20 15-19
19 Georgieff M K, Schmidt R L, Mills M M, Radmer W J, Widness J A. Fetal iron and cytochrome c status after intrauterine hypoxemia and erythropoietin administration. Am J Physiol . 1992; 262 R485-R491
20 Phelan J P, Ahn M O, Korst L M, Martin G I. Nucleated red blood cells: a marker for fetal asphyxia?. Am J Obstet Gynecol . 1995; 173 1380-1384
21 Lubetzky R, Ben-Schachar S, Mimouni F B, Dollberg S. Mode of delivery and neonatal hematocrit. Am J Perinatol . 2000; 17 163-165
22 Marwaha N, Marwaha R K, Narang A, Thusu K, Garewal G, Bhakoo O N. Routine hematological values in term newborns. Ind Pediatr . 1992; 29 1095-1099