Leukopenia and Neutropenia at Birth and Sepsis in Preterm Neonates of <32 Weeks' Gestation

Abstract

Objective This study aimed to evaluate associations between leukopenia or neutropenia at birth and risk of sepsis in very preterm neonates.

Study Design We conducted a retrospective unmatched cohort study of neonates of <32 weeks' gestation. Those with leukopenia (≤5,000/µL) were compared with a unmatched cohort without leukopenia. Comparisons were also made for patients with neutropenia and without neutropenia. The outcomes were early-onset sepsis, late-onset sepsis, and mortality.

Results We identified 271 neonates with leukopenia at birth and 271 without. Multivariable analyses identified higher odds of early-onset sepsis (adjusted odds ratio [AOR] = 4.85, 95% confidence interval [CI]: 1.29–18.20) in leukopenic neonates. Of neonates with leukopenia, 183 had both leukopenia and neutropenia and were associated with the highest odds of early-onset sepsis (AOR = 6.94, 95% CI: 1.77–27.15) compared with those with neither or with either alone.

Conclusion Leukopenia, neutropenia, and both leukopenia and neutropenia at birth were associated with early-onset sepsis in very preterm neonates.

Key Points

• Leukopenia and neutropenia combined at birth was associated with highest odds of early-onset sepsis.

• Leukopenia or neutropenia were associated with sepsis in preterm neonates.

• The risk of infection persist throughout neonatal stay in NICU.

Keywords

infant - premature - early-onset sepsis - late-onset sepsis - mortality

Authors' Contributions

J.S. and P.S.S. conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. T.B. participated in study design, data collection and interpretation, and reviewed the manuscript. J.Y. analyzed the data and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work in ensuring that questions related to its accuracy or integrity are appropriately investigated and resolved.

Publication History

Received: 07 July 2020

Accepted: 16 October 2020

Article published online:
23 November 2020

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