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Byline: Lisa M. Korst (a)(b)(c)(d), Jeffrey P. Phelan (a)(b)(c)(d), Myoung Ock Ahn (a)(b)(c)(d), Gilbert I. Martin (a)(b)(c)(d) Abstract: Objective: Our goal was to update our experience with nucleated red blood cells as a marker for fetal asphyxia and to determine whether a relationship exists beteeen the presence of nucleated red blood cells and long-term neurologic impairment. Study Design: Nucleated red blood cell data from 153 singleton term neurologically impaired neonates were compared with cord blood nucleated red blood cells of 83 term nonasphyxiated newborns. Newborns with anemia, intrauterine growth restriction, and maternal diabetes were excluded. The group of neurologically impaired neonates was separated into the following subgroups: group I, persistent nonreactive fetal heart rate pattern from admission to delivery (n=69); group II, reactive fetal heart rate on admission followed by tachycardia with decelerations and absent variability (n=47); group III, reactive fetal heart rate on admission followed by an acute prolonged deceleration (n=37). The first and highest nucleated red blood cell value and the time of nucleated red blood cell disappearance were assessed. Results: The mean number of initial nucleated red blood cells was significantly higher in the group of neurologically impaired neonates (30.3[+ or -]77.5, range 0 to 732 per 100 white blood cells) than in the control group (3.4[+ or -]3.0, range 0 to 12 per 100 white blood cells) (p Conclusion: Our ongoing study indicates that nucleated red blood cells identify the presence of fetal asphyxia. When fetal asphyxia is present, distinct nucleated red blood cell patterns are observed that relate to the timing of fetal injury. In general, intrapartum injuries are associated with lower nucleated red blood cell values. Thus our data continue to support the concept that nucleated red blood cell levels may assist in determining the timing of fetal neurologic injury. Author Affiliation: (a) Department of Obstetrics and Gynecology, The Perinatal Center, Pomona Valley Hospital Medical Center Pasadena USA (b) Department of Obstetrics and Gynecology, Cha Women's Hospital of Seoul Seoul, Korea USA (c) Department of Neonatology, Queen of the Valley Hospital Pomona, West Covina USA (d) Department of Pediatrics, University of California, Irvine, School of Medicine Orange, California USA Article Note: (footnote) * Presented at the Sixteenth Annual Meeting of the Society of Perinatal Obstetricians, Kamuela, Hawaii, February 4-10, 1996.