Citation Information :
Bernhardt GV, Jhancy M, Bernhardt LK, Shivappa P, Kumar S, Pinto JR. Cord Blood Neutrophil Phagocytic Index in Neonates Born to Anemic Mothers and in Neonates Born with Risk of Early-onset Sepsis. J South Asian Feder Obs Gynae 2021; 13 (1):26-30.
Introduction: During early life, the neutrophils as components of the innate immune system help to defend against pathogenic infections. Evaluation of cord blood neutrophil phagocytic index (NPI) has considerable value for understanding innate immune status. Few previous studies have investigated the association of maternal iron levels and neonatal immune status. The association of prenatal factors leading to increased risk of early-onset sepsis (EOS) in neonates is well understood. Neutrophils as components of the innate immune system represent the first line of defense against pathogens and are important especially during early life. Compromised neutrophil phagocytic functions and immune responses have been linked to the development of EOS in neonates.
Aims and objectives: (1) To evaluate the phagocytic index of the neutrophils in the cord blood obtained from neonates born to anemic mothers. (2) To evaluate the phagocytic index of the neutrophils in the cord blood obtained from neonates born with risk factors for developing EOS.
Materials and methods: To study NPI in neonates born to anemic mothers, 60 mothers and newborn pairs were recruited and subdivided into anemic and nonanemic groups, based on hemoglobin (Hb) levels of maternal blood. To study NPI in cord blood of neonates born with risk factors for EOS, 61 neonates with two or more risk factors for developing sepsis were recruited, along with 48 healthy infants who served as controls. Venous blood samples were collected 1.5 hours ± 20 minutes before the delivery. Five milliliters of cord blood was collected soon after childbirth.
Results: The mean NPI values and also the mean gestational age and birth weight were significantly lower (p <0.05) in neonates of anemic mothers. Positive linear correlation (inverse relationship) of r = 0.67 and p <0.05 was observed between maternal Hb and NPI. Neonates with risk of EOS had significantly (p <0.05) lower values of NPI and significantly elevated levels of C-reactive proteins (CRP).
Conclusions: There exists a significant association between maternal iron status and lowered phagocytic capacity of neutrophils, suggesting compromised innate immunity in neonates. Lowered NPI in the cord blood of infants born with risk of EOS is suggestive of the compromised immune response, which may add to the risk of developing EOS. Lowered cord blood NPI may mark early neonatal immune deficiency and immune processes in neonates. Further studies on cord blood NPI can lead to identifying NPI as an early predictor of EOS.
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