Higher White Blood Cell Counts and Band Forms in Newborns Delivered Vaginally Compared with Those Delivered by Cesarean Section

Abstract

The authors retrospectively reviewed complete blood counts in the medical records of all babies admitted to a normal newborn nursery from January through December 1989. The subjects consisted of 326 babies who were delivered vaginally (VgD) and 138 who were delivered by Cesarean section (CS). All blood samples were drawn by warmed or unwarmed heel sticks or by venipuncture. The subject's age at the time of blood drawing was similar in both VgD and CS groups (13.4 vs. 13.9 hours, P = 0.51). The number of total leukocytes, neutrophils, band forms, and platelets was significantly higher in VgD newborns than in CS newborns. The mean and standard error of the mean for each of these blood counts (each per microliter) were 23.9 x 10(9) +/- 0.33 versus 21.1 x 10(9) +/- 0.6, 14.6 x 10(9) +/- 0.26 versus 12.8 x 10(9) +/- 0.39, 1.18 x 10(9) +/- 0.08 versus 0.82 x 10(9) +/- 0.08, and 304 x 10(9) +/- 4.1 versus 286 x 10(9) +/- 0.6, respectively (P values for the first three comparisons were all less than 0.005). However, there was no difference between the two groups with regard to hemoglobin, hematocrit, and absolute number of lymphocytes, eosinophils, basophils, and monocytes (P > 0.5). It was speculated that the higher leukocyte, neutrophil, and band counts in VgD babies are the consequences of physical stress and periodic hypoxia, which are more frequent and prolonged with VgD compared with CS delivery. The authors suggest that the mode of delivery should be considered when interpreting blood counts in neonates.

The Absolute Neutrophil Count:Is It the Best Indicator for Occult Bacteremia in Infants?

“…It is believed that children and infants have similar responses to stress. 15 Our data indicate that the control group C is quite well differentiated from the bacteremia group A, but it could not be differentiated from group B.…”

The Role of Immature Granulocyte Count and Immature Myeloid Information in the Diagnosis of Neonatal Sepsis

“…After 12 hours of life no differences in the variation of leukocyte counts remained. Although a significant increase of immature neutrophil counts in vaginally delivered infants or after long labour has been previously described (Hasan et al, 1993;Schelonka et al, 1994), no significant differences in the IT-ratio were detected between the two groups (Chirico et al, 1999). In a prospective observational study including 60 preterm infants with a gestational age < 32 weeks prenatal growth retardation has been shown to be an independent factor for significantly lower counts of leukocytes, total neutrophil and immature neutrophil counts in very immature preterm infants immediately after birth when compared with AGA counterparts.…”

Mode of delivery directs the phagocyte functions of infants for the first 6 months of life

“…Labour leads to leucocytosis, which is selective for neutrophils [6±9], monocytes and natural killer (NK) cells [9,10]. Consequently, infants delivered by Caesarean section without labour have signi®cantly lower leucocyte and neutrophil counts than vaginally delivered neonates [6,8,9,11]. Furthermore, contradictory results exist concerning the effect of method of delivery on the functional activity of phagocytes.…”