Incidence, neutrophil kinetics, and natural history of neonatal neutropenia associated with maternal hypertension

Article Abstract:

A correlation between infants born with neutropenia, an abnormal decrease in the number of neutrophils in the blood, and mothers with hypertension (high-blood pressure) has been observed. Low levels of neutrophils, a type of white blood cell, are associated with leukemia, infection, rheumatoid arthritis, vitamin B12 deficiency and other disorders. Thirty-five of 72 infants born to 68 women with hypertension suffered from neutropenia. When compared to a control group, the infants with neutropenia showed both lower gestation ages and birth weights. A higher prevalence and longer duration of the disorder was observed in babies born to women with severe hypertension or HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) as opposed to pregnancy-induced hypertension. The duration of neutropenia in these infants was considered either transient (1 to 60 hours duration) or prolonged (three to 30 days duration). was observed that diminished neutrophil production was the primary cause of neutropenia as opposed to other influences such as accelerated neutrophil destruction. Nosocomial infections, infections acquired during hospitalization, occurred in eight of the neutropenic babies (27 percent) and in one (3 percent) of the control group during the first 2.5 weeks after birth. These infections occurred after the condition of neutropenia was already evident. The precise molecular mechanism responsible for the suppression of neutrophil production is unknown.

Research, Measurement

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The mechanism responsible for diminished neutrophil production in neonates delivered of women with pregnancy-induced hypertension

Article Abstract:

Neutropenia, or a decrease in neutrophils (a type of white blood cell) often develops in infants of mothers with pregnancy-related high blood pressure (hypertension). Studies show that neutropenia develops in up to 80 percent of newborns of mothers with severe hypertension. Neutropenia in the newborn increases the risk of infection. This blood condition was shown to result from a decrease in the production of neutrophils in the fetus. Three explanations have been offered to explain this observation: growth factors that promote neutrophil production are reduced; a decreased response of progenitor cells (cells that give rise to neutrophils) to growth-promoting factors occurs; or an inhibitor substance prevents the production of neutrophils. The activity of colony-stimulating factors, which promote neutrophil production, was lower in the placenta of hypertensive pregnancies compared with normal pregnancies. Progenitor cells from hypertensive and normal pregnancies did not differ in response to growth-promoting factors. However, the formation of neutrophil colonies was prevented by blood from hypertensive pregnant women, but not by blood from women with normal pregnancies. These findings suggest that in hypertensive pregnancies a factor is produced by the placenta that inhibits the production of neutrophils in the fetus, resulting in neutropenia in the newborn. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of

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Transplacental passage of recombinant human granulocyte colony-stimulating factor in women with an imminent preterm delivery

Article Abstract:

Administration of granulocyte colony-stimulating factor (CSF) to pregnant women at risk of preterm labor may stimulate fetal immune systems and reduce the risk of newborn infections. Researchers gave recombinant human granulocyte CSF to women at risk of giving birth before 30 weeks' gestation to assess the effect on newborn health. The two infants born more than 30 hours after administration of granulocyte CSF had much higher white blood cell counts in cord blood which remained high for one week after birth. These two infants did not experience any infections during their first week. Cord blood levels of white blood cells did not rise among infants born within 30 hours after granulocyte CSF was given. Human granulocyte CSF crosses the placenta from mother to fetus and may improve the newborn's outcome.

Health aspects, Newborn infants, Premature birth, Granulocyte colony-stimulating factor

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