The Effects of Labor and Delivery on Cerebral Spinal Fluid Pleocytosis in Term Neonates 1160

Abstract

Mild cerebrospinal fluid (CSF) pleocytosis is a normal finding in the newborn period. References suggest that between fifteen and twenty leukocytes may be present and represent normal physiology in the first weeks of life. It has been presumed that the presence of this mild pleocytosis is due to the physical and physiological stress of delivery, particularly the infants repeated head compressions. We assessed this hypothesis by conducting a retrospective chart review of CSF results on ninety term infants. These infants received lumbar punctures as either part of a sepsis or congenital syphilis evaluation. All patients had negative blood and CSF cultures and did not receive pretreatment with antibiotics. Traumatic lumbar punctures (RBC> 1,000/mm3) were excluded. The degree of pleocytosis was then plotted against duration of labor, including Csection deliveries without labor. No statistically significant correlation could be found. The presence and extent of a newborns CSF pleocytosis is independent of the length of labor from which he/she was born. An alternative mechanism to explain the physiologic CSF pleocytosis of the newborn must be operative. Speculation is offered.