PATTERNS OF CHANGE IN EARLY NEONATAL NUCLEATED ERYTHROCYTE COUNTS IN PRETERM DELIVERIES

Citation
Cm. Salafia et al., PATTERNS OF CHANGE IN EARLY NEONATAL NUCLEATED ERYTHROCYTE COUNTS IN PRETERM DELIVERIES, Journal of the Society for Gynecologic Investigation, 4(4), 1997, pp. 178-182
Citations number
23
Categorie Soggetti
Obsetric & Gynecology
ISSN journal
10715576
Volume
4
Issue
4
Year of publication
1997
Pages
178 - 182
Database
ISI
SICI code
1071-5576(1997)4:4<178:POCIEN>2.0.ZU;2-0
Abstract
OBJECTIVE: To examine whether changes in nucleated erythrocyte (nRBC) counts in the early neonatal period can distinguish between causes of nRBC release. METHODS: From a data set of 465 nonanomalous singleton l ive births delivered at 22-32 weeks, excluding maternal diabetes melli tus, Rh isoimmunization, and chronic hypertension, 125 cases had a com plete blood count with an nRBC count within 3 hours of life and at lea st one other value obtained within 48 hours of the first. The change i n nRBC count per deciliter was calculated (Delta nRBC) and was correla ted with antenatal fetal assessment, neonatal outcome variables, and p lacental histopathology in five categories: 1) histologic acute intrau terine inflammation, 2) uteroplacental vascular lesions, 3) intraplace ntal vaso-occlusive lesions, 4) chronic inflammation, and 5) coagulati on-related lesions. RESULTS: There were 92 cases (74%) of premature ru pture of membranes (PROM) and preterm labor/intact membranes (PTL) and 33 cases (26%) of preclampsia. In PROM/PTL, multivariate analyses dem onstrated that a higher uteroplacental vascular lesion score was relat ed to more stable nRBC counts (P = .009), whereas a higher nonmyeloid count in the initial neonatal white blood cell count was related to a more rapid decrease in Delta nRBC (combined r = 0.54, P < .0001). No f eatures were related to Delta nRBC in preeclampsia. CONCLUSION: In PRO M/PTL, but not in preeclampsia, patterns of change in the nRBC count i n the early newborn period vary with uteroplacental vascular lesions a nd acute inflammation. This may reflect differences in the mediators o f nRBC release (erythropoietin versus cytokines) and in disease acuity . Copyright (C) 1997 by the Society for Gynecologic Investigation.