Leukocytosis in Preterm Infants with Intraventricular Hemorrhage

Intraventricular hemorrhage is the most common intracranial hemorrhage in premature infants. The objective of this study was to investigate the relationship between intraventricular hemorrhage and blood leukocyte count. This was a cross-sectional simple sampling study conducted from the beginning of 2006 to 2010 in Ali-Asghar Children’s Hospital. Inclusion criteria were birth weight less than 1500 grams, and at least one cranial ultrasound performed in the first 7 days. The CBC was taken one hour after first entering the NICU. WBC count greater than 25000 cell/ml was considered as leukocytosis and ANC greater than 15000 as neutrophilia. Two hundred neonates were included in the study. Intraventricular hemorrhage was reported in 59 patients (29.5%). There was significant correlation between Intraventricular hemorrhage and mechanical ventilation (P=0.003). Significant correlation was observed between gestational age and WBC count in the first and second days (P=0.001), and between birth weight and WBC count in the first and second days (P = 0.03). There was also a correlation between WBC count in the first and second days and the first minutes Apgar score (P = 0.03), and between the fifth minute Apgar score and the first day WBC count (P=0.005). Intraventricular hemorrhage incidence was associated with mechanical ventilation and pneumothorax, but no significant correlation was found with the total peripheral leukocyte count and neutrophil count during the first 72 hours after the birth. Further studies are needed to confirm the probable role of leukocytosis in the pathophysiology of intraventricular hemorrhage.