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Effect of early postnatal neutropenia in very low birth weight infants born to mothers with pregnancy-induced hypertension

  • Park, Yang Hee (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lee, Gyung Min (Department of Pediatrics, Konyang University College of Medicine) ;
  • Yoon, Jung Min (Department of Pediatrics, Konyang University College of Medicine) ;
  • Cheon, Enn Jung (Department of Pediatrics, Konyang University College of Medicine) ;
  • Ko, Kyung Ok (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lee, Yung Hyuk (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lim, Jae Woo (Department of Pediatrics, Konyang University College of Medicine)
  • Received : 2012.08.24
  • Accepted : 2012.10.13
  • Published : 2012.12.15

Abstract

Purpose: In this study, we aimed to investigate the perinatal clinical conditions of very low birth weight (VLBW) infants born to mothers with pregnancy-induced hypertension (PIH) focusing on the effects of early postnatal neutropenia. Methods: We reviewed the medical records of 191 VLBW infants who were born at Konyang University Hospital, between March 2003 and May 2011. We retrospectively analyzed the clinical characteristics of the infants and their mothers and compared the incidence of perinatal diseases and mortality of the infants according to the presence or absence of maternal PIH and neutropenia on the first postnatal day. Results: Infants born to mothers with PIH showed an increased incidence of neutropenia on the first postnatal day (47.4%), cesarean delivery, and intrauterine growth restriction. When the infants born to mothers with PIH showed neutropenia on the first postnatal day, their incidence of respiratory distress syndrome (RDS) was increased (P=0.031); however, the difference was not found to be significant through logistic regression analysis. In all the VLBW infants, neutropenia on the first postnatal day was correlated with the development of RDS. The incidence of the other perinatal diseases involving sepsis and mortality did not significantly differ according to the presence or absence of neutropenia in infants born to mothers with PIH. Conclusion: In VLBW infants born to mothers with PIH, the incidence of neutropenia on the first postnatal day was increased and it was not significantly correlated with the development of perinatal diseases involving RDS, sepsis, and mortality.

Keywords

References

  1. Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol 1998;179:1359-75. https://doi.org/10.1016/S0002-9378(98)70160-7
  2. Roberts CL, Algert CS, Morris JM, Ford JB, Henderson-Smart DJ. Hypertensive disorders in pregnancy: a population-based study. Med J Aust 2005;182:332-5.
  3. Shah DM. Perinatal implications of maternal hypertension. Semin Pediatr Neurol 2001;8:108-19. https://doi.org/10.1053/spen.2001.25812
  4. Gasem T, Al Jama FE, Burshaid S, Rahman J, Al Suleiman SA, Rahman MS. Maternal and fetal outcome of pregnancy complicated by HELLP syndrome. J Matern Fetal Neonatal Med 2009;22:1140-3. https://doi.org/10.3109/14767050903019627
  5. Koenig JM, Christensen RD. Incidence, neutrophil kinetics, and natural history of neonatal neutropenia associated with maternal hypertension. N Engl J Med 1989;321:557-62. https://doi.org/10.1056/NEJM198908313210901
  6. Fraser SH, Tudehope DI. Neonatal neutropenia and thrombocytopenia following maternal hypertension. J Paediatr Child Health 1996;32:31-4. https://doi.org/10.1111/j.1440-1754.1996.tb01537.x
  7. Kuntz TB, Christensen RD, Stegner J, Duff P, Koenig JM. Fas and Fas ligand expression in maternal blood and in umbilical cord blood in preeclampsia. Pediatr Res 2001;50:743-9. https://doi.org/10.1203/00006450-200112000-00019
  8. Christensen RD. Neutrophil kinetics in the fetus and neonate. Am J Pediatr Hematol Oncol 1989;11:215-23.
  9. Koenig JM, Yoder MC. Neonatal neutrophils: the good, the bad, and the ugly. Clin Perinatol 2004;31:39-51. https://doi.org/10.1016/j.clp.2004.03.013
  10. Funke A, Berner R, Traichel B, Schmeisser D, Leititis JU, Niemeyer CM. Frequency, natural course, and outcome of neonatal neutropenia. Pediatrics 2000;106(1 Pt 1):45-51. https://doi.org/10.1542/peds.106.1.45
  11. Baley JE, Stork EK, Warkentin PI, Shurin SB. Neonatal neutropenia. Clinical manifestations, cause, and outcome. Am J Dis Child 1988;142:1161-6. https://doi.org/10.1001/archpedi.1988.02150110039016
  12. Carlton DP, Cho SC, Albertine KH, Davis PL, Miciak JR, Bland RD. Neutrophil depletion inhibits lung vascular injury and edema in preterm lambs. Pediatr Res 1994;35:10000327.
  13. Kim HS, Park JD, Kim BI, Choi JH, Yun CK. Association of early postnatal neutropenia and development of bronchopulmonary dysplasia in preterm infants. J Korean Pediatr Soc 1998;41:1033-60.
  14. Albertine KH, Carlton DP, Lont M, Davis PL, Bland RD. Pulmonary sequestration of neutrophils in preterm lambs with lung vascular injury. Pediatr Res 1994;35:10000389.
  15. Gluck L, Kulovich MV. Lecithin-sphingomyelin ratios in amniotic fluid in normal and abnormal pregnancy. Am J Obstet Gynecol 1973;115:539-46. https://doi.org/10.1016/0002-9378(73)90404-3
  16. Sibai BM. Hypertensive disorders of pregnancy: the United States perspective. Curr Opin Obstet Gynecol 2008;20:102-6. https://doi.org/10.1097/GCO.0b013e3282f73380
  17. Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979;95:89-98. https://doi.org/10.1016/S0022-3476(79)80096-7
  18. Burrows RF, Kelton JG. Fetal thrombocytopenia and its relation to maternal thrombocytopenia. N Engl J Med 1993;329:1463-6. https://doi.org/10.1056/NEJM199311113292005
  19. Morley CJ. Prevention of respiratory distress syndrome. In: Harvey D. Cooke UW, Levitt GA, editors. The baby under 1000 g. London: Butterworth Co, 1989:23-49.
  20. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001;163:1723-9. https://doi.org/10.1164/ajrccm.163.7.2011060
  21. Young Infants Clinical Signs Study Group. Clinical signs that predict severe illness in children under age 2 months: a multicentre study. Lancet 2008;371:135-42. https://doi.org/10.1016/S0140-6736(08)60106-3
  22. Boxer LA. Immune neutropenias. Clinical and biological implications. Am J Pediatr Hematol Oncol 1981;3:89-96.
  23. Christensen RD, Calhoun DA, Rimsza LM. A practical approach to evaluating and treating neutropenia in the neonatal intensive care unit. Clin Perinatol 2000;27:577-601. https://doi.org/10.1016/S0095-5108(05)70040-3
  24. La Gamma EF, Alpan O, Kocherlakota P. Effect of granulocyte colonystimulating factor on preeclampsia-associated neonatal neutropenia. J Pediatr 1995;126:457-9. https://doi.org/10.1016/S0022-3476(95)70469-8
  25. Doron MW, Makhlouf RA, Katz VL, Lawson EE, Stiles AD. Increased incidence of sepsis at birth in neutropenic infants of mothers with preeclampsia. J Pediatr 1994;125:452-8. https://doi.org/10.1016/S0022-3476(05)83294-9
  26. Rath W, Faridi A, Dudenhausen JW. HELLP syndrome. J Perinat Med 2000;28:249-60.
  27. Paul DA, Leef KH, Sciscione A, Tuttle DJ, Stefano JL. Preeclampsia does not increase the risk for culture proven sepsis in very low birth weight infants. Am J Perinatol 1999;16:365-72. https://doi.org/10.1055/s-2007-993886
  28. Yoon HS, Park SJ, Kim EA, Kim KS, Pi SY. Hematologic characteristics of neonates born to pregnancy-induced hypertensive mothers. J Korean Soc Neonatol 1998;5:158-66.
  29. Lee KJ, Yun SY, Lee R, Hean JH, Jung GY, Park JH, et al. Peripheral neutrophil count and respiratory failure in preterm infant. J Korean Pediatr Soc 2002;45:596-602.
  30. Chiswick ML. Prolonged rupture of membranes, pre-eclamptic toxaemia, and respiratory distress syndrome. Arch Dis Child 1976;51:674-9. https://doi.org/10.1136/adc.51.9.674
  31. Mouzinho A, Rosenfeld CR, Sanchez PJ, Risser R. Revised reference ranges for circulating neutrophils in very-low-birth-weight neonates. Pediatrics 1994;94:76-82.
  32. Yoon JJ, Kohl S, Harper RG. The relationship between maternal hypertensive disease of pregnancy and the incidence of idiopathic respiratory distress syndrome. Pediatrics 1980;65:735-9.
  33. Groneck P, Gotze-Speer B, Oppermann M, Eiffert H, Speer CP. Association of pulmonary inflammation and increased microvascular permeability during the development of bronchopulmonary dysplasia: a sequential analysis of inflammatory mediators in respiratory fluids of high-risk preterm neonates. Pediatrics 1994;93:712-8.
  34. Sharma G, Nesin M, Feuerstein M, Bussel JB. Maternal and neonatal characteristics associated with neonatal neutropenia in hypertensive pregnancies. Am J Perinatol 2009;26:683-9. https://doi.org/10.1055/s-0029-1223270

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