Text Box: THE EFFICACY OF NUCLEATED RED BLOOD CELL COUNTS AND ERYTHROPOIETIN LEVELS IN THE DETECTION AND FOLLOW-UP OF HIGH RISK NEONATES Vatansever U1, Acunas B1, Demir M1, Karasalihoglu S1, Ekuklu G1, Sener S1, Pala O1 Trakya University, Faculty of Medicine, Edirne, Turkey Objective: To determine the efficacy of nucleated red blood cell (NRBC) counts and erythropoietin (Epo) levels in the detection and follow-up of high risk neonates. Methods: The study group comprised of four groups. Group 1 included infants that were small for gestational age (SGA) (n=14), Group 2 comprised of infants born premature (n=25), Group 3 included term infants with asphyxia and Group 4 comprised of infants of diabetic mothers (n=12). Control group consisted of two subgroups. Group 5 included healthy, term infants delivered with cesarean section (n=19) and Group 6 comprised of healthy, term infants born with normal labor (n=18). Three blood samples were obtained from each infant within 12 hours (initial), 3 days and 7 days after birth to measure NRBC counts and Epo levels. Neurological examination, Denver Developmental Screening Test and imaging studies were performed to identify those patients with sequela at 3 and 6 months of .age Results: There was no statistically significant difference among the groups with regard to the initial serum Epo concentrations. A decrease in Epo levels was seen in all groups with advance in postnatal age. The initial NRBC counts were significantly lower in Groups 5 and 6 compared with other groups (p=0.002). However there was no significant difference among the study groups in terms of the initial NRBC counts. A decrease in NRBC count was observed in all groups with advance in postnatal age. The initial absolute NRBC counts were significantly higher in Group 4 compared with other groups (p=0.003). The efficacy of serum Epo concentrations in the detection of patients with sequela and those without sequela, achieved only borderline significance. On the other hand, the patients who had no pathological outcome during follow-up had lower NRBC counts when compared to the patients who were observed to have sequela or died (p=0.01 and p=0.02 respectively). Conclusion: The results of this study demostrate that serum Epo concentrations do not seem to be efficient in the discrimination of high risk neonates from healthy ones as well as in the evaluation of prognosis of those infants. NRBC count discriminates high risk neonates from healthy ones however does not allow the inter group discrimination of high risk neonates. On the other hand NRBC count is better than serum Epo concentrations in the determination of prognosis in high risk neonates. 2333