Decreased phagocytic capacity of cord blood monocytes in second- and third-born multiplets.
OBJECTIVE
To assess the risk to second- and third-borns of developing perinatal infections based on a diminished first-line immune response in comparison to the first-born.


METHODS
11 sets of twins and 2 sets of triplets (27-39 weeks of gestation, 740-3,560 g birth weight) admitted consecutively to our neonatal care unit were investigated. All were delivered by cesarean section. Phagocytosis and the expression of TNF-alpha and IL-1 in cord blood were determined immediately and 72 h after birth from peripheral blood monocytes by FACS analysis and ELISA.


RESULTS
In all second- and third-borns, phagocytosis of cord blood monocytes was significantly decreased in comparison to the first-borns (p < 0.001, p < 0.015). 72 h after birth phagocytosis determined from peripheral blood showed no significant difference between the first-borns and the second- and third-borns. Cytokine expression revealed no significant differences dependent on birth order.


CONCLUSIONS
We suggest that the observed temporarily diminished first-line immune response of second- and third-born multiplets might be the result of a short-term reduced cellular oxygenation during delivery, but has no influence on further immunological deficiency leading to a higher risk of perinatal infections.
Division of Pediatric Surgery and Surgical Research Laboratories, Department of Surgery, University Children's Hospital, Vienna, Austria. u.hallwirth@aon.at
Gerhard
G
Pomberger
Ulrike
U
Hallwirth
Heinz
H
Strohmer
Andreas
A
Spittler
Martin
M
Wald
Daniela
D
Zaknun
D001722:Birth Order; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005312:Fetal Blood / Q000166:cytology / Q000276:immunology*; D005434:Flow Cytometry; D006801:Humans; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000096:biosynthesis / Q000276:immunology; D008297:Male; D009000:Monocytes / Q000276:immunology*; D010587:Phagocytosis / Q000276:immunology*; D011247:Pregnancy; D011272:Pregnancy, Multiple; D013997:Time Factors; D014310:Triplets; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000276:immunology; D014427:Twins
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha