妊娠期高血压疾病对胎龄28~34周早产儿外周静脉血细胞计数的影响

Effect of hypertensive disorders of pregnancy on peripheral venous blood cell count in preterm infants with a gestational age of 28-34 weeks

摘要:

目的 探讨母亲妊娠期高血压疾病（hypertensive disorders of pregnancy，HDP）对胎龄28~34周早产儿外周静脉血细胞计数的影响。 方法 选取2020年1~12月昆明医科大学第一附属医院儿科收治的母亲合并HDP的胎龄28~34周早产儿227例为研究组，另选取同期收治的母亲无HDP的胎龄28~34周早产儿227例为对照组。研究组根据母亲妊娠期血压分为妊娠期高血压亚组（75例）、轻度子痫前期亚组（81例）、重度子痫前期亚组（71例）；根据早产儿出生体重分为小于胎龄儿（small for gestational age，SGA）亚组（113例）及适于胎龄儿（appropriate for gestational age，AGA）亚组（114例）。比较研究组和对照组、研究组各亚组间早产儿生后第1天外周血细胞计数的差异。 结果 研究组患儿生后第1天外周静脉血白细胞（white blood cell，WBC）计数、中性粒细胞绝对计数（absolute neutrophil count，ANC）及血小板（platelet，PLT）计数均低于对照组（P<0.05），白细胞减少症、中性粒细胞减少症发生率高于对照组（P<0.05）。亚组分析中，轻度子痫前期亚组、重度子痫前期亚组WBC计数、ANC、PLT计数均低于妊娠期高血压亚组（P<0.05）；SGA亚组WBC计数、ANC、PLT计数低于AGA亚组（P<0.05）。 结论 HDP可对早产儿外周静脉血细胞计数产生影响，这一影响在母亲子痫前期及SGA早产儿中更为显著。

Abstract:

Objective To study the effect of hypertensive disorders of pregnancy on peripheral venous blood cell count in preterm infants with a gestational age of 28-34 weeks. Methods A total of 227 preterm infants with a gestational age of 28-34 weeks who were admitted to the Department of Pediatrics, the First Hospital Affiliated to Kunming Medical University, from January to December 2020, and whose mothers had hypertensive disorders of pregnancy were enrolled as the study group. A total of 227 preterm infants with a gestational age of 28-34 weeks who were admitted during the same period and whose mothers did not have hypertensive disorders of pregnancy were enrolled as the control group. According to maternal blood pressure during pregnancy, the study group was divided into three subgroups: gestational hypertension (n=75), mild preeclampsia (n=81), and severe preeclampsia (n=71). According to the birth weight of the preterm infants, the study group was divided into two subgroups: small for gestational age (SGA) (n=113) and appropriate for gestational age (AGA) (n=114). Peripheral blood cell count on day 1 after birth was compared between the study and control groups, as well as between the subgroups of the study group. Results Compared with the control group, the study group had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count (P<0.05) and significantly higher incidence rates of leucopenia and neutropenia (P<0.05). The subgroup analysis showed that the mild preeclampsia and severe preeclampsia subgroups had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count than the gestational hypertension subgroup (P<0.05), and that the SGA subgroup had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count than the AGA subgroup (P<0.05). Conclusions Hypertensive disorders of pregnancy can affect the peripheral venous blood cell count of preterm infants, which is more significant in infants with maternal preeclampsia and SGA infants.