Correlation Analysis Of Early Neonatal Lymphocyte Subsets And Perinatal Factors

Background and objectivesNewborns,especially premature babies,because of immature development of various organs and systems and low immune function,show a unique susceptibility to severe bacterial infections,which can cause severe morbidity and mortality.With the development of perinatal technology,the immune function of newborns is increasingly concerned by domestic peripheral obstetricians.The purpose of this study is to explore the differences in early-stage neonatal lymphocyte levels and the correlation with perinatal factors,so as to provide a theoretical basis for perinatal maternal and infant health care.MethodsThe study was a retrospective cohort study of newborns.The inclusion criteria of the research subjects:(1)Newborns admitted to the neonatal intensive care unit of the First Affiliated Hospital of Zhengzhou University within 24 hours after birth from January 2018 to December 2019;(2)Lymphocyte subsets were tested on the day of birth Newborn.Exclusion criteria:(1)Those with multiple malformations or congenital genetic metabolic diseases or congenital immunodeficiency;(2)Mothers with immune diseases;(3)Incomplete data;(4)Those who died less than 24 hours after birth.According to birth gestational age(GA),it was divided into premature infant group(GA<37 weeks)and full-term infant group(GA(?)37 weeks),P<0.05 is considered statistically significant.Perform a single factor linear regression analysis on the perinatal factors and the levels of each lymphocyte subgroup,incorporate the relatively relevant perinatal factors(P<0.2)into the multiple linear regression model,and use the stepwise regression method for multiple linear regression analysis To control the interference of confounding factors(P<0.05),analyze the effects of perinatal factors on the levels of lymphocyte subsets in preterm and term infants.All subjects included signed informed consent,and this study has been approved by the hospital ethics committee.Results1.Composition and grouping of newbornsAccording to GA,495 newborns were divided into premature group(GA<37 weeks):427 cases,term group(GA≥37 weeks):68 cases.2.Perinatal data of preterm and term infantsPremature infant group Gestational age,Birth weight,Apgar 1 min,Apgar 5 min scores were significantly lower than full-term infants(P<0.001;P<0.001;P=0.001;P=0.006);cesarean section and pregnancy-induced hypertension,Premature rupture of membranes,placenta previa,hormonal application of hormones,intrauterine infections were significantly higher than term infants(P=0.001;P<0.001;P=0.010;P=0.036;P<0.001;P<0.001).There were no significant differences between the two groups in terms of gender,maternal age,Gestational diabetes mellitus GDM,amniotic fluid pollution,intrauterine asphyxia,and umbilical cord abnormalities(P>0.5).3.Comparison of lymphocyte subsets between preterm and term infantsThe absolute count of lymphocyte subsets in the premature infant group(LY#,T#,Th#,Ts#,B#,NK#)was significantly lower than that in the term infant group(p<0.001;p<0.001;p<0.001;p<0.001;P=0.04;p=0.032).There was no statistically significant difference in the percentage of lymphocyte subsets(T%,Th%,Ts%,B%,NK%,Th/Ts)between the premature infant group and the term infant group(p>0.5).4.Correlation between lymphocyte subsets and perinatal factors in preterm infantsGestational age has a negative effect on the percentage of B cells,and a positive effect on the absolute number of T cells and Ts cells;BW has a positive effect on the absolute number of LY,absolute number of Ts cells,and absolute number of B cells;B cells and T cells of baby boys The percentage is higher than that of the baby girl,and the ratio of Th cells and Th/Ts is lower than that of the baby girl;the percentage of T cells and Ts cells in cesarean section of premature infants is higher than that of vaginal delivery,and the absolute number of NK cells,LY,and B cells is higher than that of vagina Low birth rate;the higher the Apgar 1 minute score,the higher the percentage of Th cells,and the lower the NK cells;the older the maternal age,the lower the percentage of T cells;amniotic fluid pollution can promote the increase in the percentage of NK cells;the placenta previa can promote absolute LY Increase in number,absolute number of T cells,absolute number of Th and absolute number of Ts;intrauterine asphyxia can promote the increase of the ratio of helper/suppressed T lymphocytes;the application of glucocorticoids during the period can promote the percentage of Ts cells,the absolute number of LY,T cells Absolute number,absolute number of Th cells,absolute number of Ts cells,and inhibit the increase of Th/Ts ratio;intrauterine infection can promote the increase of Th/Ts ratio and the absolute number of LY,absolute number of T cells,Th cells produce the absolute number,while suppressing an increase in the percentage of Ts cells;Apgar 5 minutes scores,pregnancy-induced hypertension,of GDM,premature rupture of membranes and umbilical cord lymphocyte subsets child level has no effect.5.Correlation between lymphocyte subsets and perinatal factors in term infantsGestational age has a positive effect on the absolute number of Ts cells;BW has a positive effect on the percentage of B cells and a negative effect on the percentage of NK cells;the percentage of Th cells and the ratio of Th/Ts cells in boys is lower than that in girls;The percentage of cells and the absolute number of NK cells are lower than vaginal delivery;the higher the Apgar 1 minute score,the higher the Th/Ts cell ratio;the higher the Apgar 5 minute score,the lower the NK cell percentage;amniotic fluid pollution can promote the absolute number of LY and absolute T cells Increase in the number,absolute number of B cells,and absolute number of NK cells,while inhibiting the increase in the percentage of T cells and Th cells;premature rupture of membranes can promote the increase in the percentage of NK cells;intrauterine infection can promote the increase in the percentage of Ts cells;pregnancy Maternal age,hypertension during pregnancy,GDM,placenta previa,umbilical cord abnormalities,intrauterine asphyxia,and prenatal glucocorticoids had no effect on the level of lymphocyte subsets in term infants.Conclusions1.The absolute count of early lymphocyte subsets in preterm infants is significantly lower than that of full-term infants,suggesting that neonatal immune function is related to gestational age;2.The level of early lymphocyte subsets in neonates is affected by various perinatal factors,and the perinatal factors affecting the level of early lymphocyte subsets in preterm infants are more and more complicated than those in full-term infants.