Comparison of the NRBC/100 WBC Ratio in Blood Samples at Birth between Normal Premature Newborns and Deceased Infants

Boskabadi, Hassan; Hanafi, Farid Raza; Farhangi, Hamid

doi:10.22038/jpp.2025.88063.5549

Comparison of the NRBC/100 WBC Ratio in Blood Samples at Birth between Normal Premature Newborns and Deceased Infants

Document Type : original article

Authors

Hassan Boskabadi ¹

Farid Raza Hanafi ²

Hamid Farhangi ³

¹ Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

² Department of Pediatrics, Fellowship of Neonatology, Mashhad University of Medical Sciences, Mashhad, Iran.

³ Department of Pediatrics Hematology and Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/jpp.2025.88063.5549

Abstract

Background: This study aimed to compare the Nucleated red blood cells (NRBC)/100 White blood cells (WBC) ratio in blood samples collected at birth between normal premature newborns and deceased infants.
Methods: This cross-sectional descriptive study was conducted on preterm infants younger than 32 weeks who were admitted to the neonatal ward of Ghaem Hospital in Mashhad, Iran, from 2017 to 2024 using available sampling. Deceased infants were included in the case group, whereas those with normal development until discharge from the hospital were included in the control group. The NRBC results were compared between the two groups. All data were recorded and analyzed using SPSS version 25.
Results: The study included 277 children; 172 (62.1%) had a normal prognosis (control group) and 105 (37.9%) died (case group). The mean absolute NRBC count in deceased infants was 1718.59 ± 3693.77, approximately 13 times higher than that in infants with a normal prognosis. The NRBC/100 WBC ratio was five times higher in deceased infants than in those with normal prognosis. An absolute NRBC count >300/mm² indicated poor prognosis, with 75% sensitivity and 63% specificity. An NRBC/100 WBC ratio >11 predicted infant death with 88.6% sensitivity and 71.2% specificity (P=0.000). An absolute NRBC >190/mm² predicted infant death with 86% sensitivity and 82.2% specificity (P=0.000).
Conclusion: This study highlighted the prognostic value of NRBC counts in newborns and showed that the NRBC/100 WBC ratio was five times higher in deceased infants. Regular NRBC monitoring can guide early intervention and improve neonatal care and survival rates by identifying at-risk infants and tailoring medical treatment to enhance outcomes.

Keywords

Infants

Nucleated red blood cell

Premature

Prognosis

White blood cells

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