J Korean Soc Neonatol.  2008 Nov;15(2):151-159.

Analysis of Prenatal and Postnatal Factors Associated with Complications and Prognosis in Premature Infants with Leukemoid Reaction

• Kwon SH
• Lee BK
• Lee HJ
• Na SY
• Lee JH
• Park SY
• Kang EK
• Kim DH
• Lee K
• Kim HS

Abstract

PURPOSE
This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction.
METHODS
We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/mm3. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied.
RESULTS
Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups.
CONCLUSION
Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.

Keyword

Leukemoid reaction; Preterm infants; Bronchopulmonary dysplasia; Chorioamnionitis

MeSH Terms

Apgar Score
Birth Weight
Bronchopulmonary Dysplasia
C-Reactive Protein
Chorioamnionitis
Ductus Arteriosus, Patent
Enterocolitis, Necrotizing
Female
Gestational Age
Hemorrhage
Humans
Incidence
Infant
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Inflammation
Intensive Care, Neonatal
Leukemoid Reaction
Medical Records
Mothers
Neutrophils
Parturition
Pregnancy
Prognosis
Retinopathy of Prematurity
Retrospective Studies
Steroids
Ventilators, Mechanical
C-Reactive Protein
Steroids