Neutropenia in infants born to women with severe pre-eclampsia

Between 35 and 65% of infants born to women with severe pre-eclampsia have neutropenia (≤ 2.0 × 10⁹/l). Whether this impacts upon the incidence of neonatal sepsis at birth and/or nosocomial infection remains controversial. We studied infants born to 188 women with pre-eclampsia who delivered at ≤ 36 weeks' gestational age and those born to 188 normotensive controls who were retrospectively matched for gestational age. All infants had blood cultures on admission and complete blood count differentials daily for 1 week and biweekly thereafter. The mean gestational age for the pre-eclampsia and control groups was identical (32 ± 2 weeks), but the mean birth weight was not (1445 vs. 1648 g, respectively). There were no significant differences in neonatal mortality (3% for the pre-eclampsia and 8% for the control groups), duration of mechanical ventilation and length of hospitalization between the two groups. Neonatal thrombocytopenia (≤ 100 × 10⁹/l), which occurred in 4% of pre-eclampsia and 1% of control patients, did not correlate with maternal platelet count or neonatal course. Neutropenia occurred in 52 (28%) infants born to pre-eclamptic mothers and in 29 (15%) born to normotensive mothers (p = 0.001). Neutropenic neonates born to normotensive mothers experienced more sepsis at birth and nosocomial infections (28 and 58%) compared to neutropenic infants in the pre-eclampsia group (2 and 13%, respectively). We conclude that neutropenic infants born to pre-eclamptic mothers are not at greater risk for sepsis at birth or nosocomial infection than infants of comparable gestational age born to normotensive mothers.