[Analysis of lymphocyte immunophenotypes in neonates]. / Analiza imunofenotipova limfocita novorodencadi.

Immune system development is not completed at the end of gestation, so newborns are not fully immunocompetent. In order to evaluate the neonatal immune system status and investigate the reasons for increased neonatal susceptibility to infections, the major lymphocytes subpopulations were studied in newborns comparing the results to adult controls. The cord blood from 21 term-newborns and the peripheral blood from 23 adults were analyzed using fluorochrome labelled monoclonal antibodies and two-color flow cytometry. The percentage of T lymphocytes was lower in newborns (64.9 versus 72.8% in adults), as well as the percentage of NK cells (4.8 versus 15.5%). On the contrary, the proportions of unlabelled cells were increased in term cord blood. The percentage of cytotoxic T lymphocytes was significantly lower in term-newborns as compared to the adult controls (17.8 versus 30.3%), and so were the percentages of activated T lymphocytes (0.3 versus 3.7%) and cytotoxic non-MHC restricted T lymphocytes (0.2 versus 1.8%). The expression of CD45R0 marker on neonatal lymphocytes was very low (1%). These characteristics of newborn lymphocytes phenotype are the result of inexperienced and partly undeveloped immune system.

[Congenital anomalies of the central nervous system 1990-1993]. / Kongenitalne anomalije sredisnjega zivcanog sustava u razdoblju od 1990. do 1993. godine.

We have analyzed all available data including birth certificates, maternity records, pediatric records, and pathology reports of spontaneous and induced abortions and newborn deaths to determine the frequency of congenital anomalies of the central nervous system. We found 76 infants (34 males, 39 females and 3 of undetermined sex) with CNS anomalies during the 1990-93 period. In the same period there were 23,425 births. The frequency of CNS anomalies in this period was 32,4/10,000 births. These results are at variance with conclusions of previously published and incomprehensive studies in Croatia. Therefore, a systematic follow-up of the autopsy findings of induced and spontaneous abortions and newborn deaths in the epidemiology of CNS anomalies is clearly needed.

[Epilepsy and pregnancy]. / Epilepsija i trudnoca.

A total of 132 women with epilepsy were confined in the period from 1978-1989. Their pregnancies and outcomes were analysed. The special aim was to find out if the anticonvulsive therapy has any correlation with the occurrence of fetal malformations in the studied group of women. In 43.9% of pregnant women with epilepsy, methyl-phenobarbitone as an anticonvulsive drug was administered, while carbamazepine was applied in 13.6% cases. A combination of phenytoin and phenobarbitone was prescribed in 18.9% of cases. Primidone was the drug of choice in 8% cases and 5.3% of patients were treated with various combinations of anticonvulsive drugs. Hyperemesis, threatened spontaneous abortion and premature labor complicated significantly more pregnancies in patients with epilepsy than on controls. Pregnancies from the studied group were terminated by the cesarean section in significantly more cases (11.2%) than in the control group (5.4%). Newborns from mothers with epilepsy had a statistically lower birthweight (3173 +/- 575 g) than those born from healthy mothers (3376 +/- 510g). Fifteen newborns or 11.2% were born with congenital malformations, while among the control group of newborns only two were malformed. It is noticed that the newborns from mothers treated with phenitoin and phenobarbitone had dysmorphic anomalies of the face more frequently. The drugs mentioned above interfere with the metabolism of K vitamin and as a result of this interreaction, mothers and newborns can suffer from coagulation disorders. In conclusion it is important to mention that no anticonvulsant drug seems to be absolutely safe when used during pregnancy since each of them has a teratogenic effect on the fetus.