Haematological features in babies with perinatal asphyxia in Zimbabwe

Abstract

Background: Perinatal asphyxia is failure to establish breathing at birth. It is a common cause of neonatal mortality in developing countries. Hypoxic Ischemic Encephalopathy (HIE) is the major complication of asphyxia, resulting in permanent neurological and other multi-organ damages. Some haematological changes have also been observed in patients with this disease.

Objectives: The objective of this study was to investigate the haematological features in babies with perinatal asphyxia in Zimbabwe.

Methodology: A prospective laboratory based cross sectional study was carried out at the Sally Mugabe Hospital Neonatal Unit from December 2018 to April 2019. Routine full blood counts on samples from babies with perinatal asphyxia on their first day of life. Peripheral blood smears were examined on all those with abnormal full blood count results.

Results: Full blood counts were done on 180 babies with perinatal asphyxia of whom 103 (57%) and 77 (43%) were females and males respectively. The median white cell count and nucleated red cell count were elevated. The platelet and red cell count were decreased. Haemoglobin, haematocrit, and Mean Corpuscular Haemoglobin Concentration (MCHC) were within normal range. The Mean Corpuscular Volume (MCV) and Mean Corpuscular Haemoglobin (MCH) were increased. There was a correlation between increased nucleated red blood and white cell counts with the severity of perinatal asphyxia in the order of Asphyxia Without Hypoxic Ischemic Encephalopathy (AWHIE), Hypoxic Ischemic Encephalopathy (HIE I), HIE II, and HEI III. The most common haematological abnormalities were thrombocytopaenia 52(29%), anaemia 51(28%) and leukopaenia 28(16%). Twenty-four (47%) of anaemia patients had microcytic hypochromic anaemia. Thirty-one (47%) of 65 blood films examined exhibited immature granulocytes and 28(43%) had burr red blood cells.

Conclusion: Babies with perinatal asphyxia may present with haematological abnormalities such as anaemia, thrombocytopaenia, leukocytosis and elevated nucleated red cell count as complications of sever hypoxia. Full blood count may be a useful in the effective management of perinatal asphyxia.