Nucleated red blood cells count as first prognostic marker for adverse neonatal outcome in severe preeclamptic pregnancies.

The purpose of this study was to determine acceptability of the nucleated red blood cells counts (NRBC) as early prognostic parameter for adverse outcome in preterm neonates born from pregnancies complicated with severe preeclampsia. We analysed 77 premature newborns who were born from pregnancies with severe preeclampsia during eight years (2004-2011) in our tertiary center. Women with other pregnancy complications were excluded from the study, as well as newborns with malformations and chromosomal anomalies. Newborns were compared according to the count of nucleated red blood cells (NRBC) on the first day of life. Cut off of NRBC was determined at 40 per 100 white blood cells. We analyzed and compared birth weight, gestational age, Apgar scores in 1st and 5th minute, hypoglycemia in first day of life, need for respiratory support, neonatal infection and brain ultrasound findings at the day of discharge between the groups of newborns. We found significantly lower birth weight, gestational age and Apgar scores in case group (NRB C > 40) and significantly higher rate of infections, need for respiratory support, abnormal brain ultrasound findings, morbidity rate and adverse neonatal outcome compared to control newborns group. Increased count of nucleated red blood cells (NRBC) in preterm newborns born from pregnancies with severe preeclampsia seems to be the first significant marker for detecting adverse neonatal outcome.