GRANULOCYTE FUNCTIONAL ACTIVITY IN PREGNANT WOMEN AT HIGH RISK FOR INFECTION AND IN THEIR NEWBORN INFANTS

Objective. To characterize the specific features of peripheral blood phagocyte function in pregnant women and their newborn infants in intrauterine infection (IUI). Subjects and methods. Subjects and methods. One hundred and eighteen pregnant women delivered by cesarean section were examined and divided into groups: 1) 30 patients had placental insufficiency (PI) without bacterial or viral infection during pregnancy; 2) 30 had bacterial or viral infection during pregnancy without PI; 3) 30 had PI and bacterial or viral infection during pregnancy; 4) 28 apparently healthy women. According to the neonatal status, the authors identified the following groups: 1) 15 women having a high infection risk who gave birth to babies with the signs of hypotrophy; 2) 18 women having a high infection risk who had neonates with IUI; 3) 25 women having a high infection risk, whose neonatal babies had noninfectious complications; 4) 32 women having a high infection risk who gave birth to apparently healthy infants; 5) a control group comprising 28 apparently healthy women and their babies. The phagocytic activity of neutrophil granulocytes was determined by a flow cytometric technique; the generation of reactive oxygen species (ROS) was estimated by luminol-dependent chemiluminescence. The spontaneous and opsonized zymosan-induced production of ROS was determined in the samples of nonfractionated maternal venous blood and neonatal umbilical cord blood. The expression of activation markers on the granulocytes of venous blood from pregnant women before childbirth and neonatal umbilical cord blood, such as CD16 (Fc receptor type III), CD11b (complement receptor (CR3)), CD95 (Fas/ APO1) (a proapoptotic marker (Fas-receptor)), was investigated. Results. No statistically significant group differences were found in the levels of white blood cells in the venous blood of pregnant women just before childbirth and in the umbilical cord blood of their infants. Absorbable function evaluation revealed significantly reduced phagocytic activity in the blood of pregnant women with a high infection risk and their newborn infants. Determination of blood granulocyte functional activity showed no great differences in the spontaneous generation of ROS between the pregnant women having a high infection risk and their neonates (p=0.437), but differences in the control group (p<0.05). The induced production of ROS was, on the contrary, more intensive in the pregnant women having a high infection risk than that in the control group women. Conclusion. Decreased granulocyte functional activity was noted in the neonatal infants born to the mothers having a high infection risk and enhanced immune system activation, particularly in early neonatal IUI. The high level of induced ROS production in the maternal blood and its low level in the umbilical cord blood may serve as one of the predictors for a high probability of IUI.

pregnancy, high infection risk, neonatal intrauterine infection, granulocyte functional activity