Document Detail


The relationship between leukemoid reaction and perinatal morbidity, mortality, and chorioamnionitis in low birth weight infants.
MedLine Citation:
PMID:  20851018     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVES: Neonatal leukemoid reaction (NLR) is relatively rare and considered as a white blood cell (WBC) count ≥50×10(9)/l . The aim of this study was to investigate the association of NLR with neonatal morbidity and mortality and maternal chorioamnionitis in low birth weight infants.
METHODS: In this case-controlled retrospective study, the medical records of 1200 newborn infants with a birth weight <2500g admitted to the neonatal unit over a period of 5 years were reviewed. The infants who developed features of NLR (n=17, 1.4%) formed the study group, while the remainder without NLR, matched for gestational age and birth weight (n=123), formed the control group. A chart review was performed and salient demographic, clinical, and laboratory data abstracted. A statistical analysis was subsequently performed on this data.
RESULTS: The mean WBC and absolute neutrophil counts of infants with NLR were significantly higher than those in the control group. The peak time of NLR was at 7.9±3.6 (interquartile range (IQR) 1-30) days and on average it improved within 4.1±1.95 (IQR 2-9) days. It was noted that those infants with NLR were mostly born by vaginal delivery and their mothers had a higher rate of early rupture of the membranes and chorioamnionitis. NLR was associated with a 4-fold increase in sepsis, 20-fold increase in intraventricular hemorrhage, 54-fold increase in bronchopulmonary dysplasia, and 6-fold increase in mortality. In the study group, those infants whose mothers had chorioamnionitis had a higher rate of early rupture of the membranes and they developed sepsis and intraventricular hemorrhage more often than those whose mothers did not have clinical chorioamnionitis.
CONCLUSIONS: In low birth weight newborn infants, NLR is significantly associated with sepsis, intraventricular hemorrhage, bronchopulmonary dysplasia, and a high mortality rate. Also, those infants with NLR are more likely to be born to mothers with chorioamnionitis and they face sepsis and intraventricular hemorrhage more often.
Authors:
Ridvan Duran; Ulfet Vatansever Ozbek; Nükhet Aladağ Ciftdemir; Betül Acunaş; Necdet Süt
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Publication Detail:
Type:  Journal Article     Date:  2010-09-17
Journal Detail:
Title:  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases     Volume:  14     ISSN:  1878-3511     ISO Abbreviation:  Int. J. Infect. Dis.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e998-1001     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Pediatrics, Division of Neonatology, Trakya University Faculty of Medicine, 22030 Edirne, Turkey. ridvan_duran@yahoo.com
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