Koenig J M, Christensen R D
Division of Human Development and Aging, University of Utah School of Medicine, Salt Lake City 84132.
N Engl J Med. 1989 Aug 31;321(9):557-62. doi: 10.1056/NEJM198908313210901.
Neutropenia occurs often among the newborns of women with hypertension, but its cause, mechanism, and clinical consequences have not been adequately studied. Of 72 infants whose mothers had hypertension during pregnancy, 35 (49 percent) had neutropenia, which persisted from 1 hour to 30 days. The disorder was more prevalent among newborns whose growth had been retarded in utero (P less than 0.01), those who had been delivered prematurely (P less than 0.001), and those whose mothers had had severe hypertension (P less than 0.002) or hypertension and the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) (P less than 0.01). Kinetic investigations of circulating, marginated, storage, and proliferative neutrophils and their progenitors suggested that the neutropenia was the result of diminished neutrophil production. Noscomial infections occurred during the first 2 1/2 weeks of life in eight (23 percent) of the newborns with neutropenia, but in only one (3 percent) of those without this disorder (P less than 0.01). We conclude that the neonatal neutropenia associated with maternal hypertension is due to transiently reduced neutrophil production and is associated with an increased risk of noscomial infection. Its basic cause remains unknown.
中性粒细胞减少症在患有高血压的女性所生新生儿中经常出现，但其病因、机制及临床后果尚未得到充分研究。在72名母亲孕期患有高血压的婴儿中，35名（49%）出现中性粒细胞减少症，持续时间从1小时至30天不等。该病症在子宫内发育迟缓的新生儿中更为普遍（P<0.01），在早产的新生儿中更为普遍（P<0.001），在母亲患有严重高血压（P<0.002）或患有高血压及HELLP综合征（溶血、肝酶升高和血小板减少）的新生儿中也更为普遍（P<0.01）。对循环、边缘、储存和增殖的中性粒细胞及其祖细胞的动力学研究表明，中性粒细胞减少症是中性粒细胞生成减少的结果。8名（23%）患有中性粒细胞减少症的新生儿在出生后的前2.5周内发生了医院感染，但在未患该病症的新生儿中只有1名（3%）发生了医院感染（P<0.01）。我们得出结论，与母亲高血压相关的新生儿中性粒细胞减少症是由于中性粒细胞生成暂时减少所致，并且与医院感染风险增加有关。其根本原因仍然未知。
