| Objective:To investigate and analyze the incidence rates and related risk factors of neutropenia in hospitalized neonates,and to test the expression levels of part of molecules on the surface of neutrophils to make a preliminary understanding of neonatal granulocyte function.Subjects and Methods: Clinical data was retrospectively analyzed from neonates with neutropenia during May 1,2019 to October 31,2019 at Children's Hospital of Soochow University,3 groups were divided according to gestational age,Group 1(gestational age < 34 weeks),Group 2(34 weeks ? gestational age < 37 weeks)and Group3(gestational age ? 37 weeks),4 groups were divided according to birth weight,Group 1(body weight < 1,500g),Group 2(1,500 g ? body weight < 2,500g),Group 3(2,500 g ?body weight < 4,000g),Group 4(body weight ? 4,000g),grouped by the degree of neutropenia(mild,moderate,and severe).o compare incidence rates,degrees and ages with neutropenia in neonates of different gestational ages and birth weights.Related risk factors were analyzed with neonates without neutropenia during the same period of hospitalization with complete data as the control group,including preterm birth,gender,low birth weight,hypertension during pregnancy/preeclampsia,diabetes,amniotic fluid pollution,history of asphyxia,delivery way,premature rupture of membrane,sepsis,and NEC.Multivariate logistic regression model analysis was carried out after meaningful variables screened from univariate analysis.CD162,CXCR2,and CXCR4 molecules on the surface of neutrophils in newborns and children under non-infected state were assayed by flow cytometry to compare different expressions between newborns and children.Results:1.Incidence of neutropenia:The incidence of neutropenia in hospitalized neonates was 12.97%;that in premature and full-term babies were 17.88% and 11.46%,respectively,and the difference in incidence between groups was statistically significant(P < 0.05);incidences of neutropenia in boys and girls were 13.81% and 11.95%,respectively,and there was no significant difference in incidence between boys and girls(P > 0.05).Groups were divided according to gestational age,and the incidence rates of Group 1,Group 2and Group 3 were 36%,9.12% and 11.46%,respectively,among which there was a statistically significant difference(P < 0.05),remarkable differences exist between group 1,group 2 and group 3(P < 0.001);Groups were divided according to birth weight,and the incidence rates of Group 1,Group 2,Group 3 and Group 4 were 52.46%,16.76%,11.10%and 9.82%,respectively,among which there was a statistically significant difference(P <0.05),obvious differences exist between group 1 and group 2,group 3 and group 4,group2 and group 3(P < 0.001).2.Degree of neutropenia: Grouped by the degree of neutropenia and gestational age,we found there were 223 mildly reduced newborns,with 46,26 and 151 in each gestational age group,70 cases of moderately reduced newborns,with 17,5 and 48 in each gestational age group,3 cases with severe reduction in newborns,with 0,2 and 1 cases in each gestational age group.here was no statistically significant difference among groups(P >0.05).3.Age of newborns with neutropenia: he median age of neutropenia is 23 days.Groups were divided according to gestational age: Group 1,Group 2 and Group 3,of which median ages respectively were 24 days,17 days and 24 days,and the difference among groups was statistically significant(P < 0.05).Groups were divided according to birth weight: Group 1,Group 2,Group 3,Group 4,of which median ages respectively were 28.5 days,21 days,24 days and 25.5 days,and the difference among groups was statistically significant(P < 0.05).4.Risk factors analysis of neutropenia:The results of univariate analysis showed that low birth weight,cesarean section,amniotic fluid pollution,sepsis,NEC were associated with neutropenia,and the differences were statistically significant(P < 0.05).Multivariate logistic regression model analysis showed that low birth weight(OR 2.330,95% CI1.469-3.697,P < 0.001)and sepsis(OR 1.850,95% CI 1.020-3.356,P < 0.05)were independent risk factors for neutropenia in newborns.5.Expression levels of CD162,CXCR2,and CXCR4 on neutrophil: A total of 59non-infected blood samples were collected,including 39 neonates and 20 children.he expression level of CXCR4 on the neutrophil surface was lower than that of children,andthe expression level of CXCR2 on the neutrophil surface was higher than that of children,there were statistically significant(P<0.05),and the expression levels of CD162 on the neutrophil surface between newborns and children were not statistically significant difference(P > 0.05).he neonates were divided into groups according to gestational age,only CD162 had different expressions among three groups,and the smaller the gestational age,the lower the expression level.Further comparison was made between each two groups,and it turned out that there was a statistically significant difference between groups1 and 3(P < 0.05).he expression levels of CXCR2 and CXCR4 between the three groups were not statistically significant difference(P > 0.05).Conclusions:1.he incidence of neutropenia in hospitalized neonates was 12.97%.Premature babies in hospitalized newborns are more likely to have neutropenia than full-term babies.he smaller the gestational age,the greater the probability of occurrence.Low birth weight and sepsis are independent risk factors for neutropenia in newborns.2.he expression level of neutrophil CXCR4 was lower than that of children,and the expression level of neutrophil CXCR2 was higher than that of children.3.he expression level of neutrophil surface selectin family CD162 in preterm infants were lower than that in full-term infants,and the smaller the gestational age was,the lower the expression level would be,it may be one of the reasons that premature infants are more likely to have neutropenia. |
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