Advertisement

Nucleated Red Blood Cell Count in Maternal Peripheral Blood and Hypertensive Disorders in Pregnant Women

  • Guomin Hu
    Affiliations
    From the Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University (Central Hospital of Minhang District), Shanghai, China (GH, RG)
    Search for articles by this author
  • Rui Guan
    Correspondence
    Correspondence: Rui Guan, MD, The Department of Obstetrics and Gynecology, First Affiliated Hospital, Second Military Medical University, Changhai Road No168, Shanghai 200433, P.R. China.
    Affiliations
    The Department of Obstetrics and Gynecology, First Affiliated Hospital, Second Military Medical University, Shanghai, China (RG, LL)
    Search for articles by this author
  • Li Li
    Affiliations
    The Department of Obstetrics and Gynecology, First Affiliated Hospital, Second Military Medical University, Shanghai, China (RG, LL)
    Search for articles by this author

      Abstract

      Objective

      We investigated the correlations of nucleated red blood cell (NRBC) counts with hypertensive disorders in pregnancy (HDP) and fetal umbilical blood flow velocity.

      Materials and Methods

      We recruited 282 patients with HDP as experimental group including 107 with mild pre-eclampsia (A1 group), 100 with severe pre-eclampsia (A2 group) and 75 with eclampsia (A3 group), and 215 normal pregnant women as control group. Maternal peripheral venous blood was collected and isolated cells were stained with Wright-Giemsa. We estimated NRBC counts according to laboratory routine and Doppler ultrasound examinations were employed to measure the systolic/diastolic (S/D) ratios of fetal ductus venosus, umbilical artery and middle cerebral artery.

      Results

      The NRBC counts in A1, A2 and A3 groups were higher than control group (all P < 0.01). The S/D ratios in control, A1, A2 and A3 groups increased orderly (P < 0.05). Receiver operating characteristic curve analysis demonstrated that the sensitivity and specificity of NRBC count and S/D ratios in diagnosing HDP were 96.50% and 96.28%; 93.60% and 98.14%; 94.30% and 94.88% 99.30% and 100%, respectively. Pearson and Spearman correlation analysis revealed that the NRBC and S/D ratios were correlated with gestational age at birth, amniotic fluid volume, premature birth, mechanical ventilation, neonatal intensive care unit admission, neonatal asphyxia, birth weight, fetal distress, APGAR score, pH value, arterial oxygenation tension, bicarbonate and base excess (all P < 0.05). The NRBC count was positively associated with the S/D ratios (all P < 0.05).

      Conclusions

      Our results provide evidence that NRBC count in patients with HDP increased significantly, showing positive correlations with umbilical S/D ratios.

      Key Indexing Terms

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of the Medical Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ferrazzani S.
        • Luciano R.
        • Garofalo S.
        • et al.
        Neonatal outcome in hypertensive disorders of pregnancy.
        Early Hum Dev. 2011; 87: 445-449
        • Bennett W.L.
        • Gilson M.M.
        • Jamshidi R.
        • et al.
        Impact of bariatric surgery on hypertensive disorders in pregnancy: retrospective analysis of insurance claims data.
        Br Med J. 2010; 340: c1662
        • Maloney K.F.
        • Heller D.
        • Baergen R.N.
        Types of maternal hypertensive disease and their association with pathologic lesions and clinical factors.
        Fetal Pediatr Pathol. 2012; 31: 319-323
        • Tuovinen S.
        • Raikkonen K.
        • Pesonen A.K.
        • et al.
        Hypertensive disorders in pregnancy and risk of severe mental disorders in the offspring in adulthood: the Helsinki Birth Cohort Study.
        J Psychiatr Res. 2012; 46: 303-310
        • Wang I.K.
        • Muo C.H.
        • Chang Y.C.
        • et al.
        Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study.
        Can Med Assoc J. 2013; 185: 207-213
        • Hutcheon J.A.
        • Lisonkova S.
        • Joseph K.S.
        Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy.
        Best Pract Res Clin Obstet Gynaecol. 2011; 25: 391-403
        • George E.M.
        • Granger J.P.
        Endothelin: key mediator of hypertension in preeclampsia.
        Am J Hypertens. 2011; 24: 964-969
        • Giguere Y.
        • Charland M.
        • Bujold E.
        • et al.
        Combining biochemical and ultrasonographic markers in predicting preeclampsia: a systematic review.
        Clin Chem. 2010; 56: 361-375
        • Akolekar R.
        • Minekawa R.
        • Veduta A.
        • et al.
        Maternal plasma inhibin A at 11-13 weeks of gestation in hypertensive disorders of pregnancy.
        Prenat Diagn. 2009; 29: 753-760
        • Li J.
        • Kobata K.
        • Kamei Y.
        • et al.
        Nucleated red blood cell counts: an early predictor of brain injury and 2-year outcome in neonates with hypoxic-ischemic encephalopathy in the era of cooling-based treatment.
        Brain Dev. 2014; 36: 472-478
        • Baer V.L.
        • Lambert D.K.
        • Henry E.
        • et al.
        Among very-low-birth-weight neonates is red blood cell transfusion an independent risk factor for subsequently developing a severe intraventricular hemorrhage.
        Transfusion. 2011; 51: 1170-1178
        • Kil T.H.
        • Han J.Y.
        • Kim J.B.
        • et al.
        A study on the measurement of the nucleated red blood cell (nRBC) count based on birth weight and its correlation with perinatal prognosis in infants with very low birth weights.
        Korean J Pediatr. 2011; 54: 69-78
        • Cremer M.
        • Weimann A.
        • Szekessy D.
        • et al.
        Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis.
        J Perinatol. 2013; 33: 622-626
        • Hayes B.C.
        • Cooley S.
        • Donnelly J.
        • et al.
        The placenta in infants >36 weeks gestation with neonatal encephalopathy: a case control study.
        Arch Dis Child Fetal Neonatal Ed. 2013; 98: F233-F239
        • Walsh B.H.
        • Boylan G.B.
        • Dempsey E.M.
        • et al.
        Association of nucleated red blood cells and severity of encephalopathy in normothermic and hypothermic infants.
        Acta Paediatr. 2013; 102: e64-e67
        • Namavar Jahromi B.
        • Ahmadi N.
        • Cohan N.
        • et al.
        Comparison of the umbilical artery blood gas, nucleated red blood cell, C-reactive protein, and white blood cell differential counts between neonates of diabetic and nondiabetic mothers.
        Taiwan J Obstet Gynecol. 2011; 50: 301-305
        • Gasparovic V.E.
        • Ahmetasevic S.G.
        • Colic A.
        Nucleated red blood cells count as first prognostic marker for adverse neonatal outcome in severe preeclamptic pregnancies.
        Coll Antropol. 2012; 36: 853-857
        • Marzieh Akbarzadeh Z.M.
        • Zare Najaf
        • Vaziri Farideh
        • et al.
        The effects of decreasing maternal anxiety on fetal oxygenation and nucleated red blood cells count in the cord blood.
        Iran J Pediatr. 2014; 24: 285-292
        • Salas S.P.
        • Russo N.M.
        [Analysis of the main ethical conflicts in the 2008 declaration of Helsinki and the proposed changes in the new version].
        Rev Med Chil. 2014; 142: 475-480
        • Thornton C.
        • Makris A.
        • Ogle R.
        • et al.
        Generic obstetric database systems are unreliable for reporting the hypertensive disorders of pregnancy.
        Aust N Z J Obstet Gynaecol. 2004; 44: 505-509
        • Fabry I.G.
        • Richart T.
        • Chengz X.
        • et al.
        Diagnosis and treatment of hypertensive disorders during pregnancy.
        Acta Clin Belg. 2010; 65: 229-236
        • Echtermeyer F.
        • Harendza T.
        • Hubrich S.
        • et al.
        Syndecan-4 signalling inhibits apoptosis and controls NFAT activity during myocardial damage and remodelling.
        Cardiovasc Res. 2011; 92: 123-131
        • Rath W.
        • Fischer T.
        The diagnosis and treatment of hypertensive disorders of pregnancy: new findings for antenatal and inpatient care.
        Dtsch Arztebl Int. 2009; 106: 733-738
        • Huppertz B.
        Placental origins of preeclampsia: challenging the current hypothesis.
        Hypertension. 2008; 51: 970-975
        • Yang X.Z.J.
        • Liu G.
        Correlation of maternal fetal nucleated red blood cells levels and activity of erythrocyte immune adherent regulatory factor in pregnant women with severe pre-eclampsia.
        J Pract Obstet Gynecol. 2010; 11: 013
        • Hebbar S.
        • Misha M.
        • Rai L.
        Significance of maternal and cord blood nucleated red blood cell count in pregnancies complicated by preeclampsia.
        J Pregnancy. 2014; 2014: 496416
        • Dunning K.
        • Safo A.O.
        The ultimate Wright-Giemsa stain: 60 years in the making.
        Biotech Histochem. 2011; 86: 69-75
        • Nagueh S.F.
        • Bhatt R.
        • Vivo R.P.
        • et al.
        Echocardiographic evaluation of hemodynamics in patients with decompensated systolic heart failure.
        Circ Cardiovasc Imaging. 2011; 4: 220-227
        • Lakhkar B.N.
        • Rajagopal K.V.
        • Gourisankar P.T.
        Doppler prediction of adverse perinatal outcome in PIH and IUGR.
        Ind J Radiol Imag. 2006; 16: 109-116
        • Parmar L.P.
        • Mwango G.N.
        • Wambugu M.N.
        • et al.
        The umbilical artery resistive index and the cerebro-placental ratio as a predictor of adverse foetal outcome in patients with hypertensive disorders of pregnancy during third trimester.
        East Cent Afr JSurg. 2014; 18: 94-97
        • Baschat A.A.
        Neurodevelopment following fetal growth restriction and its relationship with antepartum parameters of placental dysfunction.
        Ultrasound Obstet Gynecol. 2011; 37: 501-514
        • Li Danyu F.J.
        • Zhang L.E.I.
        The pathogenesis on abnormal S/D ratio and the reference ranges of S/D ratio of umbilical artery flow in different gestational weeks.
        J Liaoning Med Univ. 2013; 34: 55-56
        • Yang Zhi H.M.
        • Haiyan N.I.U.
        Correlation between umbilical artery S/D ratio and perinatal outcome in patients with pregnant induced hypertension.
        Chin Med Sci J. 2014; 4: 63-64
        • Goel M.
        • Dwivedi R.
        • Gohiya P.
        • et al.
        Nucleated red blood cell in cord blood as a marker of perinatal asphyxia.
        J Clin Neonatol. 2013; 2: 179-182