| Peripheral blood cell counts of prematurely born, small for gestational age neonates |
Mara Zuiderwijk, Sophie Groene 
, Enrico Lopriore
, Vincent Bekker
, Michiel Schoenaker |
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Willem Alexander Children’s Hospital, Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands |
Correspondence:
Vincent Bekker, Email: v.bekker@lumc.nl
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Received: 23 December 2025 • Revised: 27 February 2026 • Accepted: 11 March 2026 |
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| Abstract |
Background
Neonates born small for gestational age (SGA) are at an increased risk of multiple severe complications, including infections. This suggests that immune cells and other peripheral blood cells may be affected.
Purpose
Here we aimed to investigate whether SGA severity affects complete blood count and leukocyte differentiation of preterm neonates with a gestational age (GA) of <35 weeks and identify clinical factors that influence cell counts.
Methods
This retrospective cohort study investigated the complete blood count sampled within 72 hours after birth in 1,940 preterm neonates admitted to the neonatal intensive care unit of Leiden University Medical Center. The neonates were divided into extreme SGA (<3rd birth weight percentile), moderate SGA (>3rd to <10th birth weight percentile), and controls (>10th birth weight percentile).
Results
After multivariate analysis, extremely SGA neonates showed significantly decreased neutrophil, monocyte, lymphocyte, and thrombocyte counts. Thrombocyte counts were significantly lower in moderately SGA neonates than controls. In contrast, SGA status had no significant effect on erythrocyte count or hemoglobin concentration.
Conclusion
Blood cell counts of extremely SGA neonates were decreased, mainly in the white blood cell line. The mechanisms underlying these decreased counts in SGA infants, especially their clinical effects, remain unclear. |
| Key Words:
Preterm infants, Growth, Human milk, Macronutrient |
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