Neonatal neutrophil counts are higher in which mode of delivery?

• A. Cesarean section without labor
• B. Vaginal delivery with labor
• C. Cesarean with labor
• D. Preterm with PROM

Answer: (D)

Neonatal neutrophil counts rise in response to inflammation and fetal stress around birth. The stress of labor itself can mobilize neutrophils, but when infection is present, especially with preterm PROM, the fetus is exposed to intra-amniotic infection such as chorioamnionitis. This triggers a robust inflammatory response, with the fetal bone marrow producing and releasing more neutrophils into circulation. Therefore, a neonate born preterm with PROM is most likely to have higher neutrophil counts due to this inflammatory exposure, compared with other delivery scenarios that involve less infection-related inflammation.