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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Nucleated red blood cells in neonates with hypoxic ischaemic encephalopathy treated with hypothermia: A worthwhile prognostic biomarker for clinicians in LMIC?
SAJCH South African Journal of Child Health, Volume 17, No. 3, Article e1969, Year 2023
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Description
Background. Neonatal hypoxic ischaemic encephalopathy (HIE) is a leading cause of term neonatal death worldwide, with a higher incidence in low-to middle-income settings. Objective. To investigate whether nucleated red blood cell (nRBC) counts could predict severity of HIE and outcomes in term neonates treated with therapeutic hypothermia (TH). Methods. We conducted a retrospective sub-study at Tygerberg Hospital in Cape Town, South Africa. The review included all cooled neonates’ clinical records and blood samples from a National Health Laboratory Services database. One experienced neurodevelopmental expert assessed patients over a period of 12 months. Results. Twenty-five files out of a total of 100 were excluded owing to missing data. In accordance with the Thompson HIE score, the cohort was classified as mild (56%), moderate (27%), and severe (17%). All included patients (n=75) had full blood counts within 6 hours of delivery. nRBC were detected in 52% of the samples. There was no correlation between nRBC category and HIE severity (p=0.265). Raised nRBCs (≥30 cells/100 white blood cells (WBCs)) were more frequent in infants who died than in those who survived (p=0.008). Infants with nRBC counts ≥30 cells/100 WBCs had an increased likelihood of having cerebral palsy or impaired neurodevelopment (p=0.013). Conclusion. The study demonstrated a significant association between an early increase in nRBC counts in HIE infants treated with TH, and both short-and long-term outcomes. A larger multicentre study is required to better understand the relationship between nRBC counts and HIE in the era of cooling in our local setting. © 2023, South African Medical Association. All rights reserved.
Authors & Co-Authors
Mfingwana, Lunga
South Africa, Stellenbosch
Stellenbosch University
South Africa, Tygerberg
Tygerberg Hospital
van Zyl, Jeanetta I.
South Africa, Tygerberg
Tygerberg Hospital
Smith, Johan
South Africa, Stellenbosch
Stellenbosch University
South Africa, Tygerberg
Tygerberg Hospital
Rutherford, Mary A.
South Africa, Stellenbosch
Stellenbosch University
United Kingdom, London
King's College London
Kali, Gugulabatembunamahlubi Tenjiwe Jabulile
South Africa, Stellenbosch
Stellenbosch University
South Africa, Tygerberg
Tygerberg Hospital
Statistics
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.7196/SAJCH.2023.v17i3.1969
ISSN:
19943032
Research Areas
Disability
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Study Locations
South Africa