Abstract
The immunologic functions in preterm (PT) and small-for-gestational-age (SGA) babies from birth till 6 months of age was assessed and their nutritional status and morbidity were studied. Sera were collected from 50 infants of both sexes at birth and at 3 and 6 months of age. 20 were full-terms 15 PT and 15 SGA. Measurements were made of body weight; body height; head chest and midarm circumference; and skinfold thickness. Serum immunoglobulin and C3 complement levels were estimated by Martins technique. Neutralizing antibody (NA) against vaccinia virus acquired transplacentally by the neonates was estimated in the cord blood. Cellular immunity against vaccinia virus at the 1st month of life was assessed by studying the kinetics of vesiculation and pustulation following smallpox vacciantion. At 3 and 6 months delayed cutaneous hypersensitivity (DHR) was studied by intradermal injections of old tuberculin streptokinase streprodornase 0.1 ml candida antigen and 0.1 ml heat-killed smallpox vaccine. Among the 3 groups of infants PT were the smallest and their average birth weight the lowest. PT had a higher growth rate than SGA. 8 SGA babies caught up to full-terms but the remaining 7 were still light. Immunoglobulins were measured in blood as was NA. SGA babies had impaired early IgA and IgM synthesis which may be due to intrauterine undernutrition. Specific CMI was poor in PT neonates but adequate in SGA babies. Both term and PT babies at 3 months showed comparable DHR against various recall antigens. However it was impaired in only 5 SGA babies which persisted up to 6 months of age. Severe intrauterine growth retardation (IUGR) was found in 5 SGA infants who had a mean birth weight of 1.86 kg. The remaining 10 those with a mean birth weight of 2.2 kg. had mild IUGR. CMI seemed to mature poorly in these 5 severely affected infants.
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