Perinatology.  2018 Mar;29(1):39-47. 10.14734/PN.2018.29.1.39.

The Effect of Acute Histologic Chorioamnionitis on Hematologic Profile of Preterm Fetuses

• Kang HS
• Park JW
• Kim HS

• KMID: 2409111
• DOI: http://doi.org/10.14734/PN.2018.29.1.39

Abstract

OBJECTIVE
To characterize the hematologic profile of preterm fetuses delivered spontaneously with acute histologic chorioamnionitis (HCA).
METHODS
This was a retrospective cohort study. The relationship between the presence of acute HCA and the change of hematologic profile was examined in 109 singleton pregnant women who were admitted and delivered between 24-32 weeks of gestation. Cases without results of placental histologic examination, cord blood cell count, and the differential count were excluded. From the cord blood, hemoglobin concentration, hematocrit, mean corpuscular volume, total leucocyte count and the differential count, platelet count, normoblast count, and umbilical arterial pH were obtained. All the observed values were corrected for gestational age by calculating a ratio between the observed and mean expected value for gestational age.
RESULTS
1) The prevalence of acute HCA was 60.6% (66/109); 2) newborns with acute HCA had a higher median corrected leucocyte counts and corrected percentage of neutrophil in the differential count and a lower median corrected percentage of lymphocyte in the differential count than those without acute HCA; 3) neutrophilia was significantly frequent in newborns with acute HCA than in those without acute HCA; and 4) acute HCA was not associated with detectable changes in percentage of monocyte, eosinophil, basophil, and normoblast in the differential count, hemoglobin concentration, hematocrit, erythrocyte counts, mean corpuscular volume, platelet counts, or umbilical arterial pH.
CONCLUSION
The hematologic profile of preterm fetuses delivered spontaneously with acute HCA is characterized by significant changes in the total leucocyte count, neutrophil percentage, and lymphocyte percentage.

Keyword

Hematologic test; Preterm; Chorioamnionitis; Fetus

MeSH Terms

Basophils
Cell Count
Chorioamnionitis*
Cohort Studies
Eosinophils
Erythroblasts
Erythrocyte Count
Erythrocyte Indices
Female
Fetal Blood
Fetus*
Gestational Age
Hematocrit
Hematologic Tests
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Lymphocytes
Monocytes
Neutrophils
Platelet Count
Pregnancy
Pregnant Women
Prevalence
Retrospective Studies

Figure

• 

  Fig. 1. Comparison of the fetal blood absolute and corrected leucocyte counts. (A) Fetuses with acute histologic chorioamnionitis had higher median absolute leucocyte counts than those without acute histologic chorioamnionitis (absolute leucocyte count median 10.5 [range, 1.1-35.4] vs. 6.6 [range, 2.4-15.9] ×109/L, P<0.001). (B) Corrected leucocyte counts by gestational age was also higher in fetuses with acute histologic chorioamnionitis (corrected leucocyte count median 2.31 [range, 0.27-8.68] vs. 1.11 [range, 0.41-3.97], P<0.001). HCA, histologic chorioamnionitis.

• 

  Fig. 2. Comparison of the fetal blood percentage of neutrophil in the differential count and corrected neutrophil counts. (A) Median percentage of neutrophil was higher in fetuses with acute histologic chorioamnionitis than in those without acute histologic chorioamnionitis (median percentage of neutrophil in the differential count 53.5% [range, 5.0-85.1] vs. 32.5% [range, 5.0-71.9], P<0.001). (B) Corrected median percentage of neutrophil counts was also higher in fetuses with acute histologic chorioamnionitis (corrected median percentage of neutrophil counts 5.51 [range, 0.43-11.2] vs. 2.20, [range 0.26-5.75], P<0.001). HCA, histologic chorioamnionitis.

• 

  Fig. 3. Comparison of the fetal blood percentage of lymphocyte in the differential count. (A) Median percentage of lymphocyte was lower in fetuses with acute histologic chorioamnionitis than those without acute histologic chorioamnionitis (median percentage of lymphocyte in the differential count 32.4% [range, 8.3-86.0] vs. 53.0% [range, 18.1-85.0], P<0.001). (B) Corrected percentage of lymphocyte counts was also lower in fetuses with acute histologic chorioamnionitis (corrected median percentage of lymphocyte counts 0.41 [range, 0.12-1.26] vs. 0.69 [range, 0.26-1.24], P<0.001). HCA, histologic chorioamnionitis

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