Effects of pregnancy induced hypertension on hemocyte parameters and diagnosis of early-onset sepsis in premature newborns

  Background   Pregnancy induced hypertension (PIH) is a non-specific inflammatory disease. It can induce the activation of maternal circulating leukocytes, and increase the systemic inflammatory response. However, few studies focus on the changes of the hemocyte parameters of the offspring in early neonatal period.

  Objective   To explore the effects of PIH on the hemocyte parameters and the diagnosis of early-onset sepsis (EOS) in premature newborns.

  Methods   This was a nested case control study. The study subjects were premature infants delivered by PIH pregnant women in our hospital from October 1, 2016 to November 30, 2020. And the control group were premature infants, who were delivered by the non-PIH mothers’ in the same month and the difference of gestational age was within one week. The differences of hemocyte parameters and the incidence of clinical diagnosed EOS between the two groups were compared. In addition, in the infants with clinical diagnosed EOS, the proportion of whom met the EOS diagnostic criteria only due to the abnormal hemocyte parameters was compared between the two groups.

  Results   In the present study,104 paired premature infants were enrolled in the PIH group and the non-PIH group, respectively. Compared to the non-PIH group, the leukocytes decreased (all P＜0.05) in the PIH group at admission (8.59 ± 3.89 × 10⁹/L vs 11.60 ± 4.97 × 10⁹/L), at 48 h after birth (8.08 ± 3.22 × 10⁹/L vs 10.66 ± 4.39 × 10⁹/L) and at 7 days after birth (8.77 ± 2.58 × 10⁹/L vs 11.55 ± 4.89 × 10⁹/L). The platelet level in PIH group was also lower than that in non PIH group (P＜0.05) at admission (201 ± 60 × 10⁹/L vs 253 ± 64 × 10⁹/L), at 48 h after birth (180 ± 73 × 10⁹/L vs 257 ± 81 × 10⁹/L) and at 7 days after birth (222 ± 92 × 10⁹/L vs 313 ± 103 × 10⁹/L). There was no significant difference in the diagnosis rate of EOS between the two groups (20.19% vs 23.08%, P=0.611). However, in the infants with clinical diagnosed EOS, the proportion of infants met the EOS diagnostic criteria only due to the abnormal hemocyte parameters in the PIH group was higher than that in the non-PIH group (12/21 vs 2/24, χ²=12.452, P<0.001).

  Conclusion  The hemocyte parameters of premature newborns of PIH pregnancies are lower than those without exposure to PIH, and this condition may enlarge the diagnosis of EOS in the premature infants of the PIH pregnancies.