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

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.