title: Intrauterine growth restriction and the innate immune system in preterm infants of ≤32 weeks gestation.
abstract: OBJECTIVE
  Intrauterine growth restriction (IUGR) is a well-known cause of adverse neonatal outcomes. As it may have an impact on innate immune responses, we aimed to investigate several parameters of the innate immune response in preterm infants of ≤32 weeks gestation who were small for gestational age (SGA).
  
  
  METHODS
  We compared clinical data of SGA (n = 20) and appropriate for gestational age (AGA; n = 124) newborns with a gestational age of ≤32 weeks. We investigated full blood counts at birth and on days 3 and 7 of life and cytokine immune responses in a human whole cord blood assay.
  
  
  RESULTS
  SGA preterm infants had a higher risk of the combined outcome mortality or bronchopulmonary dysplasia. Numbers of white blood cells and neutrophils were diminished in SGA infants at birth and on day 3. At birth, platelet counts were also diminished while the number of nucleated red blood cells tended to be elevated in SGA infants. After stimulation of whole blood cell cultures with lipopolysaccharides, the concentrations of interleukin-6 and interleukin-10 were significantly lower in SGA preterm infants compared to AGA infants.
  
  
  CONCLUSIONS
  SGA infants differ remarkably from AGA infants in full blood counts and in their ability to mount an immune response. Whether the quantitative deficiency in innate immunity plays a role for adverse outcomes needs to be investigated in larger future trials.
authors.affiliation: Department of Paediatrics, University of Lübeck, Lübeck, Germany.
authors.forename: Birte
authors.initials: B
authors.lastname: Tröger
authors.forename: Thilo
authors.initials: T
authors.lastname: Müller
authors.forename: Kirstin
authors.initials: K
authors.lastname: Faust
authors.forename: Meike
authors.initials: M
authors.lastname: Bendiks
authors.forename: Michael K
authors.initials: MK
authors.lastname: Bohlmann
authors.forename: Susanne
authors.initials: S
authors.lastname: Thonnissen
authors.forename: Egbert
authors.initials: E
authors.lastname: Herting
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Göpel
authors.forename: Christoph
authors.initials: C
authors.lastname: Härtel
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000276:immunology / Q000401:mortality; D016022:Case-Control Studies; D002478:Cells, Cultured; D004906:Erythrocyte Count; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D005317:Fetal Growth Retardation / Q000097:blood / Q000276:immunology* / Q000401:mortality; D005865:Gestational Age; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D007958:Leukocyte Count; D008070:Lipopolysaccharides / Q000494:pharmacology; D008297:Male; D009504:Neutrophils / Q000276:immunology; D016017:Odds Ratio; D010976:Platelet Count; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D008070:Lipopolysaccharides; D016753:Interleukin-10