Fetal lymphocyte subpopulations in red blood cell iso‐immunised pregnancies

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Abstract
Objective To study the association between fetal anaemia and alterations in lymphocyte subpopulations.Design Cross‐sectional study.Setting The Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London.Subjects Forty‐three red blood cell iso‐immunised pregnancies undergoing cordocentesis at 19 to 38 weeks gestation.Main outcome measures Fetal blood haemoglobin concentration, erythroblast count and lymphocyte subpopulations.Results The mean T (CD3+), B (CD19+), T‐helper (CD4+), T‐suppressor/cytotoxic (CD8+) and natural killer (NK: CD16 +/CD56 +) cell counts in the anaemic fetuses were significantly lower than the appropriate normal mean for gestation (CD3 + : t=–3.25, P < 0.01; CD19 + : t=–2‐14, P < 0.05; CD4+: t–4.03, P < 0.001; CD8+ : t=–3.39, P < 0.01 and CD16 +/CD56+ : t=–3.49, P < 0.01). Furthermore, there was a significant association between the decrease in T lymphocyte number and the degree of fetal anaemia (r= 0.342, P < 0.05).Conclusions Fetuses from red blood cell iso‐immunised pregnancies exhibit nonselective lymphopenia that is proportional to the degree of anaemia.