The influence of gestational age and postnatal age on neonatal cerebrospinal fluid parameters

Abstract

Objective To study the influence of gestational age (GA) and postnatal age on neonatal cerebrospinal fluid parameters. Method From January 2013 to December 2015, the results of WBC counts, glucose and protein concentrations of cerebro-spinal fluid (CSF) were collected from neonates admitted to neonatal department of our hospitals. The neonates were assigned into different groups according to their GA and postnatal age. The CSF parameters were compared between different groups, and the changes of CSF parameters were analyzed. STATA 12.0 software was used for statistical analysis. Result A total of 1 410 infants were included. 516 (36.6%) cases were preterm infants. 1 208 cases (85.7%) received antibiotics before lumbar puncture. WBC counts in CSF between preterm and term infants showed no significant differences (upper reference limit, 12.5×106/L). CSF glucose in term infants (lower reference limit, 1.8 mmol/L) was higher than preterm infants (lower reference limit, 1.6 mmol/L). CSF protein in preterm infants (upper reference limit, 226.6 mg/dl) was significantly higher than term infants (upper reference limit, 140.3 mg/dl). CSF WBC counts decreased with the growth of postnatal age in preterm infants (regression coefficients -0.030, P=0.035). CSF protein also declined significantly with the increase of postnatal age in term infants (regression coefficients -1.254, P<0.001). CSF glucose showed no significant decrease with the increase of postnatal age (regression coefficients -0.009, P=0.012). Conclusion GA and postnatal age did not produce an effect on WBC counts of CSF. The preterm infants had lower glucose level and higher protein level in CSF. CSF protein declined significantly with the increase of GA and postnatal age. Key words: Cerebrospinal fluid; Reference values; Lumbar puncture; Influence factor