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Fetal immunodeficiency: a consequence of placental insufficiency
B Thilaganathan1, N Plachouras, G Makrydimas
1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital School of Medicine, London, UK.
Objective:
To study the effect of placental insufficiency on fetal lymphocyte subpopulations.
Study Design:
Cross sectional study of 19 growth retarded fetuses undergoing cordocentesis at 24 to 37 weeks gestation. Flow cytometry was used to enumerate fetal blood lymphocyte subpopulations.
Results:
The mean T (CD3+), B (CD19+), T-helper (CD4+), T-suppressor/cytotoxic (CD8+) cell counts and the CD4 to CD8 ratio in the growth retarded fetuses were significantly lower than respective normal mean for gestation (CD3+: z = 3.66, P < 0.001; CD19+: z = 2.18, P < 0.05; CD4+: z = 3.76, P < 0.001; CD8+: z = 2.26, P < 0.05; and CD4/CD8: z = 2.27, P < 0.05). There were significant associations between the decrease in the T lymphocyte subpopulations and the degree of fetal acidaemia.
Conclusions:
Growth retarded fetuses demonstrate immune abnormalities that could be attributed to intrauterine starvation.