Gray P H, Rodwell R L
Department of Neonatology, Mater Mothers' Hospital, South Brisbane, Queensland, Australia.
Eur J Pediatr. 1999 Jan;158(1):71-3. doi: 10.1007/s004310051013.
One hundred and six neonates of 24-32 weeks gestation born to hypertensive mothers and 106 concurrent control infants of normotensive mothers were evaluated to determine the relationship between maternal hypertension and neonatal neutropenia and the risk of nosocomial infection developing in neutropenic infants. Complete blood counts were performed on both cohorts and retrospectively evaluated. Neutropenia was diagnosed using published reference ranges for infants with birth weight <1500 g and > 1500 g. Evidence of nosocomial infection based on a positive blood culture with supportive clinical signs of sepsis was documented. The incidence of neutropenia among infants of hypertensive mothers was not significantly different from that among infants of normotensive mothers (21% vs 24%), but the duration of neutropenia was significantly longer in the infants of hypertensive mothers (P = 0.0001). Nosocomial infection was more frequent in neutropenic than the non-neutropenic hypertensive mothers' infants (55% vs 12%, P = 0.0002).
Although there is no difference in the incidence of neonatal neutropenia between infants of hypertensive mothers and those of normotensive mothers, the former group has an increased risk of nosocomial infection in neutropenic infants of hypertensive mothers. This may be related to prolonged neutropenia which was found in these infants in the present study.
对106例孕周为24 - 32周的高血压母亲所生新生儿以及106例同期血压正常母亲所生对照婴儿进行评估,以确定母亲高血压与新生儿中性粒细胞减少之间的关系,以及中性粒细胞减少婴儿发生医院感染的风险。对两组婴儿均进行全血细胞计数并进行回顾性评估。根据已发表的出生体重<1500 g和>1500 g婴儿的参考范围诊断中性粒细胞减少。记录基于血培养阳性及败血症支持性临床体征的医院感染证据。高血压母亲所生婴儿中性粒细胞减少的发生率与血压正常母亲所生婴儿相比无显著差异(21%对24%),但高血压母亲所生婴儿中性粒细胞减少的持续时间显著更长(P = 0.0001)。中性粒细胞减少的高血压母亲所生婴儿医院感染比非中性粒细胞减少的高血压母亲所生婴儿更频繁(55%对12%,P = 0.0002)。
虽然高血压母亲所生婴儿与血压正常母亲所生婴儿的新生儿中性粒细胞减少发生率无差异,但前者中中性粒细胞减少的高血压母亲所生婴儿发生医院感染的风险增加。这可能与本研究中这些婴儿出现的中性粒细胞减少持续时间延长有关。