
Introduction: Increase in the number of circulating Nucleated Red Blood Cell (NRBC) may result from various stimuli. NRBC count in umbilical venous blood of neonates has been reported as a possible marker of perinatal asphyxia. Aims The aim of the study was to correlate NRBC /100 WBC count with perinatal outcome in normal and pre-eclamptic women. Materials and Methods: It was a prospective case controlled study performed on 120 normotensive and 120 pre-eclamptic women. At delivery 1 ml of umbilical cord blood and 1ml of maternal blood was collected and analyzed for NRBC. Mean cord blood NRBC /100 WBC count was correlated with perinatal outcome in normal and pre-eclamptic women. Results: The mean maternal and cord blood NRBC counts in pre-eclamptic women was significantly higher than normotensive women (p<0.001). As the nucleated RBC count increased in maternal blood and cord blood, there was statistically highly significant decrease in mean neonatal birth weight and mean APGAR score and statistically highly significant increase in NICU admission and perinatal mortality in all women and pre-eclamptic women. Conclusion: Neonates with elevated cord blood NRBC counts are more likely to have low birth weight, low APGAR score, neonatal ICU admission and perinatal mortality. Cord blood NRBC count is a simple test which is cost-effective. It provides valuable information about the well being of the newborn. The determination of NRBC count in cord blood can be used as an additional tool in the diagnosis of fetal asphyxia and predicting early perinatal outcome.