Association of BPD and IVH with early neutrophil and white counts in VLBW neonates with gestational age <32 weeks

J Perinatol. 2008 Sep;28(9):604-10. doi: 10.1038/jp.2008.65. Epub 2008 Jun 19.

Abstract

Objective: To investigate associations between early low neutrophil count from routine blood samples, white blood count (WBC), pregnancy complications and neonatal outcomes for very low birth weight infants (VLBW <or=1500 g) with gestational age <32 weeks.

Study design: Information was abstracted on all infants admitted to level III neonatal intensive care units in Wisconsin 2003 to 2004. A total of 1002 VLBW neonates (78%) had differential and corrected total white counts within 2 (1/2) h of birth. Data analyses included frequency tables, binary logistic, ordinal logistic and ordinary regression.

Result: Low neutrophil count (<1000 per microl) was strongly associated with low WBC, pregnancy complications and antenatal steroids. Low neutrophil count predicted bronchopulmonary dysplasia severity level (odds ratio, OR: 1.7, 95% confidence interval, CI: 1.1 to 2.7) and intraventricular hemorrhage grade (OR: 2.2, 95% CI: 1.3 to 3.8).

Conclusion: Early neutrophil counts may have multiple causes interfering with their routine use as an inflammatory marker. Nonetheless, low neutrophil count has consistent independent associations with outcomes.

MeSH terms

  • Bronchopulmonary Dysplasia / etiology*
  • Bronchopulmonary Dysplasia / pathology
  • Cerebral Hemorrhage / etiology*
  • Cerebral Hemorrhage / physiopathology
  • Cerebral Ventricles*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature / blood*
  • Infant, Very Low Birth Weight / blood*
  • Leukocyte Count*
  • Neutropenia / complications
  • Neutropenia / etiology
  • Neutrophils / pathology*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications
  • Prenatal Care
  • Severity of Illness Index
  • Steroids / adverse effects

Substances

  • Steroids