title: Underweight full-term Indian neonates show differences in umbilical cord blood leukocyte phenotype: a cross-sectional study.
abstract: BACKGROUND
  While infections are a major cause of neonatal mortality in India even in full-term neonates, this is an especial problem in the large proportion (~20%) of neonates born underweight (or small-for-gestational-age; SGA). One potential contributory factor for this susceptibility is the possibility that immune system maturation may be affected along with intrauterine growth retardation.
  
  
  METHODS
  In order to examine the possibility that differences in immune status may underlie the susceptibility of SGA neonates to infections, we enumerated the frequencies and concentrations of 22 leukocyte subset populations as well as IgM and IgA levels in umbilical cord blood from full-term SGA neonates and compared them with values from normal-weight (or appropriate-for-gestational-age; AGA) full-term neonates. We eliminated most SGA-associated risk factors in the exclusion criteria so as to ensure that AGA-SGA differences, if any, would be more likely to be associated with the underweight status itself.
  
  
  RESULTS
  An analysis of 502 such samples, including 50 from SGA neonates, showed that SGA neonates have significantly fewer plasmacytoid dendritic cells (pDCs), a higher myeloid DC (mDC) to pDC ratio, more natural killer (NK) cells, and higher IgM levels in cord blood in comparison with AGA neonates. Other differences were also observed such as tendencies to lower CD4:CD8 ratios and greater prominence of inflammatory monocytes, mDCs and neutrophils, but while some of them had substantial differences, they did not quite reach the standard level of statistical significance.
  
  
  CONCLUSIONS
  These differences in cellular lineages of the immune system possibly reflect stress responses in utero associated with growth restriction. Increased susceptibility to infections may thus be linked to complex immune system dysregulation rather than simply retarded immune system maturation.
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Rathore
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Deepa
authors.initials: D
authors.lastname: Nair
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Saimah
authors.initials: S
authors.lastname: Raza
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Savita
authors.initials: S
authors.lastname: Saini
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Reeta
authors.initials: R
authors.lastname: Singh
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Obstetrics & Gynecology, Maulana Azad Medical College, New Delhi, India.
authors.forename: Reva
authors.initials: R
authors.lastname: Tripathi
authors.affiliation: Department of Neonatology, Maulana Azad Medical College, New Delhi, India.
authors.forename: Siddarth
authors.initials: S
authors.lastname: Ramji
authors.affiliation: Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
authors.forename: Aruna
authors.initials: A
authors.lastname: Batra
authors.affiliation: Department of Pediatrics, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
authors.forename: Kailash C
authors.initials: KC
authors.lastname: Aggarwal
authors.affiliation: Department of Pediatrics, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
authors.forename: Harish K
authors.initials: HK
authors.lastname: Chellani
authors.affiliation: Department of Pediatrics, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
authors.forename: Sugandha
authors.initials: S
authors.lastname: Arya
authors.affiliation: Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Neerja
authors.initials: N
authors.lastname: Bhatla
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Paul
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Aggarwal
authors.affiliation: Department of Obstetrics & Gynecology, General Hospital, Gurgaon, Haryana, India.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Department of Pediatrics, General Hospital, Gurgaon, Haryana, India.
authors.forename: Umesh
authors.initials: U
authors.lastname: Mehta
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Shailaja
authors.initials: S
authors.lastname: Sopory
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Uma Chandra Mouli
authors.initials: UC
authors.lastname: Natchu
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Shinjini
authors.initials: S
authors.lastname: Bhatnagar
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India; National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi, India.
authors.forename: Vineeta
authors.initials: V
authors.lastname: Bal
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India; National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi, India.
authors.forename: Satyajit
authors.initials: S
authors.lastname: Rath
authors.affiliation: Pediatric Biology Centre, Translational Health Science and Technology Institute, Gurgaon, Haryana, India.
authors.forename: Nitya
authors.initials: N
authors.lastname: Wadhwa
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005312:Fetal Blood / Q000166:cytology; D005317:Fetal Growth Retardation / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007194:India; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood*; D008214:Lymphocytes / Q000502:physiology*; D008297:Male; D008423:Maternal Age; D009504:Neutrophils / Q000502:physiology*; D010641:Phenotype; D055815:Young Adult
chemical_list: D007075:Immunoglobulin M