The Clinical Significance of Extreme Leukocytosis among Newborns: A Retrospective Cohort Study

Abstract

Objective The aim of the study is to examine the clinical significance of extreme leukocytosis (>40,000 cells/µL) at birth among neonates.

Study Design Data were retrospectively collected on 208 infants with leukocytosis >40,000 cells/µL and on matched normal controls as determined in complete blood counts obtained on the first day of life.

Results There were no significant group differences in birth weight, Apgar's score, timing of respiratory support, hospitalization in special care units or rehospitalization during the first month of life. All neonates with leukocytosis received antibiotics. The blood cultures of both groups were negative. A multivariate analysis showed that leukocytosis did not predict either the presence of symptoms associated with sepsis among neonates or hospitalization in a neonatal special care unit.

Conclusion Extreme leukocytosis on the first day of life is a poor predictor of infection. Clinicians should decide upon treatment according to risk factors and symptoms but not according to the degree of leukocytosis.

Key Points

• Extreme leukocytosis on the first day of life is a poor predictor of infection.

• Clinicians should decide upon treatment according to risk factors and symptoms.

• Leukocytosis was not predictive of a higher risk of morbidity in neonates.

Keywords

leukocytosis - neonatal sepsis - complete blood count - blood culture - antibiotic treatment

Note

This work was performed in partial fulfillment of the MD thesis requirements of the Sackler Faculty of Medicine, Tel Aviv University (OG).

^* These authors contributed equally to this work.

Publication History

Received: 13 January 2022

Accepted: 11 July 2022

Accepted Manuscript online:
21 July 2022

Article published online:
29 December 2022

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