INCREASED INCIDENCE OF SEPSIS AT BIRTH IN NEUTROPENIC INFANTS OF MOTHERS WITH PREECLAMPSIA

Neutropenia is often found at birth in infants born to mothers with pr eeclampsia, and is most likely present in utero. To determine whether this neutropenia is associated with an increased incidence of early-on set sepsis, we reviewed the hospital records of 301 low birth weight i nfants of mothers with preeclampsia. Early-onset sepsis was proved if the result of a culture of blood or cerebrospinal fluid in the first 4 8 hours of life was positive, or presumed if culture results were nega tive but two or more clinical signs of sepsis were present and the att ending neonatologist believed that an infant was infected and needed a t least 7 days of antibiotic therapy. Forty-eight percent of low birth weight infants of mothers with preeclampsia had neutropenia at less t han 12 hours of age. Infants with neutropenia had mothers with more se vere preeclampsia, were more premature (30 weeks vs 32 weeks), weighed less (1097 gm vs 1615 gm), and were more likely to be small for gesta tional age. Although maternal and obstetric risk factors for infection were less common in the group with neutropenia, rates of proven or pr esumed early-onset sepsis were higher (14% vs 2%; p <0.001). Sepsis wa s proved in 6% of infants with neutropenia and in none of the infants without neutropenia (p = 0.03). A logistic regression analysis of the relative effects of birth weight, gestational age, and absolute neutro phil count on the incidence of sepsis revealed that only a low absolut e neutrophil count correlated significantly with an increased risk of early-onset sepsis in infants with neutropenia.