General Obstetrics and Gynecology ObstetricsNucleated red blood cells in infants of mothers with asthma☆
Section snippets
Material and methods
We prospectively studied two groups of term infants (38-41 weeks of gestation by last menstrual period, confirmed by early ultrasound scans), appropriate for gestational age (by Lubchenco intrauterine growth charts10) who were born vaginally at the Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, between January 1, 1998, and December 31, 2001. Infants were recruited whenever three of the authors (Y. L., D. M., G. S. M.) were on call. Group 1 consisted of 28 infants of mothers with
Results
In the asthma group, 20 women were diagnosed with mild intermittent asthma, 2 women were diagnosed with mild persistent asthma, 5 women were diagnosed with moderate asthma, and 1 woman was diagnosed with severe persistent asthma. There were no 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 (Table).Characteristic Mothers
Comment
We found that maternal asthma during pregnancy is associated with an increase in nucleated RBC and lymphocyte counts (both markers of chronic intrauterine hypoxia7, 9, 21, 22, 23) in term appropriate-for-gestational-age infants. Moreover, hematocrit levels were also elevated significantly in the asthma group. We excluded small-for-gestational-age infants, an important confounding variable. We also excluded infants with other factors that were associated with a potential increase in absolute
Acknowledgements
We thank Dr Emilia Klebanov, hematology laboratory, for assistance in the performance of blood smear analysis for this study.
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Cited by (15)
Implications of an Elevated Nucleated Red Blood Cell Count in Neonates with Moderate to Severe Hypoxic-Ischemic Encephalopathy
2022, Journal of PediatricsCitation Excerpt :There are reports of a relationship between high NRBC count after birth and adverse outcomes, particularly worse neurodevelopmental outcomes.1-9 Such factors as multiple pregnancy, intrauterine growth restriction, maternal firsthand or secondhand smoking, maternal asthma, and maternal diabetes have been reported to affect NRBC count at birth.18-22 Our previous work attempted to clarify the implications of an elevated NRBC.
Elevated Nucleated Red Blood Cells in Neonates with Down Syndrome and Pulmonary Hypertension
2019, Journal of PediatricsCitation Excerpt :Alternatively, a fetus with Down syndrome may have an exaggerated response to the normal levels of intrauterine hypoxia. Nucleated red blood cell counts (and to a less known extent, higher MCV) may be a useful indication of exposure to intrauterine hypoxia, as they are known to be elevated in other situations where the fetus is exposed to hypoxia such as maternal smoking (active or passive),17,18 maternal sleep apnea,19 maternal asthma,20 and maternal diabetes.11 Furthermore, as reviewed recently by Papamatheakis et al, chronic intrauterine hypoxia may lead to PPHN through pulmonary vascular remodeling.6
Low risk of adverse obstetrical and perinatal outcome in pregnancies complicated by asthma: A case control study
2016, Respiratory MedicineCitation Excerpt :While several studies have reported an association between maternal asthma and adverse pregnancy outcome such as pre-eclampsia [3,4], gestational diabetes [5,6], placenta praevia [4], premature rupture of the membranes (PROM) [5], postpartum hemorrhage [5,7], anemia [7], caesarean delivery [7–11], malformations [12], small for gestational age (SGA) [10,13,14], low birth weight (LBW) [11,15,16], and preterm delivery [4,15], others have not found an association [11,16–19]. In general, larger database studies have reported increased risks [4,5,13,14], whereas smaller clinical prospective studies have not found significantly increased risks [6,7,18,20,21]. This discrepancy may be caused by variation in study size, regular follow-up visits in prospective studies, and lack of information on asthma characteristics, including severity, treatment and incidence of exacerbations [15].
Maternal Asthma and Placental Morphometry: Effects of Severity, Treatment and Fetal Sex
2008, PlacentaCitation Excerpt :Fetal hypoxia influences villous development and vascular morphogenesis but its origins vary. Increased numbers of nucleated erythrocytes and elevated Hcts have been reported in neonates of mothers with asthma [50] and, though suggestive of fetal hypoxic stress, we found no changes in fetal Hct. However, we confirmed reduced maternal FEV1, and elevated maternal Hct, in the presence of an exacerbation and a male fetus.
Nucleated Red Blood Cells as Markers of Perinatal Adaptation in Preterm Neonates Receiving Minimally Invasive Surfactant Therapy
2022, American Journal of PerinatologyCord blood erythropoietin and cord blood nucleated red blood cells for prediction of adverse neonatal outcome associated with maternal obesity in term pregnancy: prospective cohort study
2017, Journal of Maternal-Fetal and Neonatal Medicine
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Reprint requests: Shaul Dollberg, MD, Department of Neonatology, Lis Maternity Hospital, Tel Aviv-Sourasky Medical Center, 6 Weizman St, Tel Aviv, 64239, Israel. E-mail: [email protected]