Pattern of daily weights among low birth weight neonates in the neonatal intensive care unit: data from a multihospital health-care system

Early-Onset Neutropenia in Small-for-Gestational-Age Infants

“…16 We found that the thrombocytopenia of SGA was more severe in neonates with the most severe growth restriction (birth weight less than first percentile) than in those with moderate or mild growth restriction (first to 10th percentile). However, we did not see that same pattern in neutrophil counts in the current study.…”

“…38 This is a rational alternative explanation, but it seems to us that if G-CSF production were defective in utero and then reestablished after birth, it might take much longer to generate neutrophils than would the immediate release of an inhibitor from an otherwise readyto-go system. Our previous study on thrombocytopenia in SGA neonates 16 and the present work suggest to us that the neutropenia and thrombocytopenia associated with SGA are more directly linked with fetal growth restriction than with maternal hypertension. This conclusion is also the one reached by Wirbelauer et al, namely that it is SGA status, not high maternal blood pressure, that is associated with neonatal neutropenia.…”

“…We did not include women with the International Classification of Diseases, Revision 9 code 6424 (mild or nonspecific), because in our previous studies we found that this definition includes transient, resolved, or mild hypertension and that eliminating this code reduces heterogeneity. 16 No specific guidelines for administering intravenous immunoglobulin (IVIG) and recombinant granulocyte colonystimulating factor (rG-CSF) were sanctioned by the Intermountain Healthcare NICUs during this period, but general guidelines were available. 7 Early thrombocytopenia was defined as $2 platelet counts ,150 000/mL during the first week after birth.…”

“…Of 201 infants with neutropenia of SGA, 129 (64%) also had early thrombocytopenia, defined as $2 platelet counts ,150 000/mL during the first week. 16 Nucleated Red Blood Cells, I/T Ratios, IVIG, and rG-CSF Among the 3650 SGA neonates, 2981 had a nucleated red blood cell count (NRBC/mL) recorded on the day of birth. The NRBC count inversely correlated, somewhat, with the neutrophil count during the first days after birth (Fig 5) (r = 0.262; P , .001).…”

“…7 Early thrombocytopenia was defined as $2 platelet counts ,150 000/mL during the first week after birth. 16 SGA neonates were matched 1:1 with neonates from the same hospitals born during the same period of time who were not SGA. Matching was performed on the basis of gestational age (61 week) and birth month (61 month).…”