Effect Of Perinatal Factors On Lymphocyte Subsets Of Premature Infants

Objective: This study aims to explore the effect of perinatal factors on the early lymphocyte subsets of premature infants,and to provide theoretical basis for the immune function of premature infants and clinical prevention and treatment of immune related diseases.Methods: From October 2019 to March 2021,the 161 cases of premature infants without any congenital immune deficiency,congenital genetic metabolic diseases,pregnant women without related serious immune diseases and complete perinatal data were selected as the research objects.All the research objects were collected 3ml peripheral venous blood within 24 hours after birth and placed in the anticoagulant tube,which was professionally controlled by the Central Laboratory of our hospital The percentage of lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+,NK%,B%)were detected.The gestational age,birth weight,gender,mode of delivery,Apgar 1min score,Apgar 5min score,maternal age,premature rupture of membranes,amniotic fluid pollution,preeclampsia,primipara,prenatal hormones,gestational diabetes mellitus,maternal infection with HBV,residence during pregnancy and other perinatal data were recorded.First,the continuous independent variables and discontinuous independent variables were analyzed by univariate analysis.The influence of discontinuous independent variables on lymphocyte subsets of premature infants was compared by U test or t test between the two groups.The influence of continuous independent variables on lymphocyte subsets was analyzed by simple linear regression analysis.The perinatal factors with P<0.05 in the results of univariate analysis were included in the multiple linear regression model Type.Multiple linear regression analysis was conducted by enter regression method to control the interference of confounding factors to analyze the influence of perinatal factors on the level of lymphocyte subsets in early preterm infants.Results: The results of univariate analysis:(1)The percentage of lymphocyte subsets in preterm infants with or without amniotic fluid pollution,premature rupture of membranes and gestational diabetes mellitus was not statistically significant(P>0.05).There was no correlation between maternal age,Apgar 5min score and the percentage of lymphocyte subsets in preterm infants(P>0.05).(2)The regression coefficient and 95% confidence interval between gestational age and CD4+,CD4+/CD8+,CD8+%,were 1.212(0.329,2.095),0.156(0.049,0.264),-1.434(-1.976,-0.891),respectively(P<0.05).(3)The regression coefficient and 95% confidence interval between birth weight and CD3+,CD4+,CD4+/CD8+,CD8+%,were 0.005(0.001,0.008),0.009(0.005,0.014),0.001(0.000,0.001),-0.005(-0.007,-0.002),respectively(P<0.05).(4)The regression coefficients and95% confidence intervals of Apgar 1min score and CD3+,CD4+,CD4+/CD8+ were1.432(0.286,2.577),2.065(0.716,3.414)and 0.198(0.032,0.365),respectively(P<0.05).(5)There were significant differences in CD8+% [21.85(19.33,25.75)vs 20.60(17.05,24.85)],NK%[5.15(2.60,9.55)vs 4.00(2.10,6.15)],CD4+%[53.20(48.95,59.30)vs 57.70(53.00,63.35)],CD4+/CD8+[2.46(1.91,2.88)vs 2.81(2.15,3.58)] between men and women(P<0.05).(6)There was significant difference in CD4+% [54.85(48.40,60.30)vs57.10(51.50,63.40)] between cesarean delivery and natural delivery(P<0.05).(7)There were significant differences in CD3+% [83.10(76.25,85.95)vs 77.75(71.75,83.25)],CD8+% [22.10(18.50,28.65)vs 21.05(17.50,24.15)] between preterm infants whose mothers used prenatal hormones and preterm infants who did not use hormones(P<0.05).(8)There were significant differences in CD3+% [88.20(76.30,90.80)vs 79.35(73.00,83.60)],CD4+%[66.00(52.50,70.70)vs 55.20(49.50,60.30)],B%[6.00(2.40,11.00)vs9.65(7.40,13.65)],NK%[2.20(0.90,3.50)vs 4.75(2.68,7.63)](P<0.05).(9)The difference of CD3+%[77.40(71.40,83.30)vs 81.10(74.98,85.35)] and CD4+%[54.30(48.70,59.30)vs 56.40(51.00,62.73)] between primiparas and non primiparas was statistically significant(P<0.05).(10)There was significant difference in NK%[5.90(2.68,13.53)vs 4.00(2.45,7.00)] between preeclampsia mothers and non preeclampsia mothers(P<0.05).(11)There was significant difference in CD3+%[81.55(75.10,84.40)vs77.70(71.35,84.10)] between preterm infants born in rural areas and those born in urban areas(P<0.05).2.The results of multivariate analysis:(1)After controlling for confounding factors,there was no correlation between residence during pregnancy and percentage of lymphocyte subsets in preterm infants(P>0.05).(2)The regression coefficient and 95% confidence interval between gestational age and CD4+,CD8+% of preterm infants were 0.912(0.099,1.724),-1.100(-1.796,-0.404),respectively,which were statistically significant(P<0.05),while gestational age and CD4+/CD8+ ratio of preterm infants were no longer statistically significant(P>0.05).(3)The regression coefficient and 95% confidence interval between birth weight and CD3+%,CD4+%,were 0.004(0.001,0.008)and 0.006(0.002,0.010),respectively,which were statistically significant(P<0.05),but there was no statistical significance between birth weight and CD8+%,CD4+/CD8+ ratio(P>0.05).(4)The regression coefficients and 95% confidence intervals of Apgar 1min score and CD3+、CD4+,CD4+/CD8+ were 1.109(0.032,2.186),1.315(0.224,2.407)and 0.181(0.021,0.341),respectively(P<0.05).(5)The regression coefficients and 95% confidence intervals of CD8+,NK,CD4+,CD4+/CD8+ were 1.756(0.019,3.494),2.131(0.642,3.620),-3.972(-6.323,-1.621),-0.481(-0.815,-0.147),respectively,with statistical significance(P<0.05).(6)The regression coefficient and 95% confidence interval were-10.798(-14.286,-7.310),which were statistically significant(P<0.05).(7)The regression coefficient and 95% confidence interval of CD3+% and CD8+% of preterm infants born to mothers using prenatal hormone were 3.733(1.407,6.060),which were statistically significant(P<0.05),but the comparison of CD8+% was no longer statistically significant(P>0.05).(8)The regression coefficient and 95% confidence interval were 3.898(0.201,7.594)and-3.220(-5.684,-0.756),respectively,which were statistically significant(P<0.05),while the comparison of CD3+,NK% was no longer statistically significant(P>0.05).(9)The regression coefficient and 95% confidence interval of CD3+,CD4+% of preterm infants born to primipara and non primipara were-2.916(-5.190,-0.642)and-10.869(-14.453,-7.285),respectively,with statistical significance(P<0.05).(10)The regression coefficient and 95% confidence interval were 3.997(2.247,5.748),which were statistically significant(P<0.05).Conclusion: Perinatal factors affect the development and differentiation of lymphocyte subsets in preterm infants.Gestational age,birth weight,gender,Apgar 1min score,mode of delivery,HBV infection in pregnant women,use of glucocorticoids,preeclampsia and primipara are the independent influencing factors of lymphocyte subsets in preterm infants.