分娩对产妇和新生儿免疫状况的影响

Effects of delivery on maternal and neonatal immune states.

应用流式细胞技术检测了共４０例正常孕妇分娩前后和新生儿脐血的白细胞和淋巴细胞亚群。其中阴道分娩组２０例，选择性剖宫产组２０例。结果：分娩前后母体白细胞总数和中性粒细胞、ＮＫ细胞活性以及ＣＤ８、ＣＤ１９亚群均相差不显著，而产后母血ＣＤ４亚群升高，ＣＤ３、ＣＤ４／ＣＤ８亦升高；剖宫产或阴道分娩者母体和新生儿淋巴细胞亚群相差不显著，但阴道分娩新生儿的白细胞总数、中性粒细胞比例、单核细胞和ＮＫ细胞显著升高。提示：产后母体免疫状况由孕期的抑制转入增强，分娩方式对母体免疫状况无明显影响，但阴道分娩使新生儿的非特异性免疫功能增强，对新生儿有益。

Objective:To determine effects of delivery on maternal and neonatal immune states. Design:Forty normal term pregnancies were divided into two groups according to their modes of delivery, elective Cesarean group ( n= 20) and vaginally delivered group (n=20).Maternal blood was collected before and after delivery, and the umbilical blood was collected at-birth. The whole blood count and lymphocyte subpopulations of the samples were measured with Coulter counter and flow cytometry. Results:Maternal CD 4 cells and the ratio between CD 3,CD 4 and CD 8 were increased after delivery, while total number of leukocytes, activities of neutrophils and natural killer cells, and CD 8, CD 1 9 subpopulations showed no significant change. The mode of delivery had no obvious effect on maternal and neonatal lymphocyte subpopulations. However, neonates by vaginal delivery had higher total number of white blood cells, higher ratios of neutrophils, monocytes and natural killer cells than those by Cesarean section. Conclusion: The suppressed maternal immune state during pregnancy is reversed after the delivery. The mode of vaginal delivery may be immunologically beneficial to the neonates.