Golomb Oryan, Schushan-Eisen Irit, Maayan-Metzger Ayala, Elisha Naama, Strauss Tzipora, Mazkereth Ram
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Neonatology, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.
Am J Perinatol. 2024 May;41(S 01):e470-e476. doi: 10.1055/a-1906-9048. Epub 2022 Jul 21.
The aim of the study is to examine the clinical significance of extreme leukocytosis (>40,000 cells/µL) at birth among neonates.
Data were retrospectively collected on 208 infants with leukocytosis >40,000 cells/µL and on matched normal controls as determined in complete blood counts obtained on the first day of life.
There were no significant group differences in birth weight, Apgar's score, timing of respiratory support, hospitalization in special care units or rehospitalization during the first month of life. All neonates with leukocytosis received antibiotics. The blood cultures of both groups were negative. A multivariate analysis showed that leukocytosis did not predict either the presence of symptoms associated with sepsis among neonates or hospitalization in a neonatal special care unit.
Extreme leukocytosis on the first day of life is a poor predictor of infection. Clinicians should decide upon treatment according to risk factors and symptoms but not according to the degree of leukocytosis.
· Extreme leukocytosis on the first day of life is a poor predictor of infection.. · Clinicians should decide upon treatment according to risk factors and symptoms.. · Leukocytosis was not predictive of a higher risk of morbidity in neonates..
本研究旨在探讨新生儿出生时白细胞极度增多（>40,000个/微升）的临床意义。
回顾性收集了208例白细胞增多（>40,000个/微升）的婴儿以及出生第一天全血细胞计数确定的匹配正常对照的数据。
两组在出生体重、阿氏评分、呼吸支持时间、在特殊护理病房住院或出生后第一个月再次住院方面无显著差异。所有白细胞增多的新生儿均接受了抗生素治疗。两组血培养均为阴性。多因素分析显示，白细胞增多既不能预测新生儿败血症相关症状的存在，也不能预测新生儿在特殊护理病房住院情况。
出生第一天白细胞极度增多对感染的预测价值不大。临床医生应根据危险因素和症状而非白细胞增多程度来决定治疗方案。
·出生第一天白细胞极度增多对感染的预测价值不大。·临床医生应根据危险因素和症状来决定治疗方案。·白细胞增多不能预测新生儿更高的发病风险。
