AMERICAN JOURNAL OF PERINATOLOGY/VOLUME 9, NUMBER 4 July 1992
EFFECT OF LABOR AND DELIVERY ON NEONATAL POLYMORPHONUCLEAR LEUKOCYTE NUMBER AND FUNCTION Victor C. Herson, M.D., Charlotte Block, B. A., Leonard I. Eisenfeld, M.D., Eufronio Maderazo, M.D., and Peter J. Krause, M.D.
The susceptibility of the neonate to increased morbidity and mortality from infection is thought to be due, at least in part, to impaired host defenses. Among the various arms of the immune system, the polymorphonuclear leukocyte (PMN) plays a key role. Several investigators have documented PMN dysfunction in the neonatal period, including defects in adherence,1 chemotaxis,2 and intracellular killing3 that are most pronounced in stressed infants.4 Previous investigators have noted PMN quantitative and functional differences in neonates based on route of delivery and the presence or absence of labor.56 Recently, adults with blunt trauma7 or burns,8 situations known to have increased infection rates, have been observed to have marked PMN dysfunction, thought to be the result of intravascular complement activation, resulting in PMN deactivation and dysfunction. We therefore speculated that labor and delivery might exert similar adverse effects on neonatal PMN function. The present study was designed to determine whether there are differences in neonatal PMN number and motility based on the route of delivery and the presence or absence of labor and, if so, whether
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The ability of the neonate to mount an adequate polymorphonuclear leukocyte (PMN) response, either quantitatively or functionally, is impaired. To assess whether neonatal PMN number and function are altered by labor and delivery, three groups of infants were studied: cesarean section without labor (10), cesarean section after labor (10), and vaginal delivery (11). PMN counts were higher in the groups undergoing labor (p