Management of Polycythemia in Neonates

Abstract

Polycythemia is defined as a venous hematocrit above 65%. The hematocrit in a newborn peaks at 2 h of age and decreases gradually after that. The relationship between hematocrit and viscosity is almost linear till 65% and exponential thereafter. Increased viscosity of blood is associated with symptoms of hypo-perfusion. Clinical features related to hyperviscosity may affect all organ systems. Neonates born small for gestational age (SGA), infants of diabetic mothers (IDM), and multiple births are at risk for polycythemia. They should therefore undergo screening at 2, 12, and 24 h of age. Polycythemia may be symptomatic or asymptomatic and guidelines for the management of both types based on the current evidence are provided in the protocol.

Delayed cord clamping in term large‐for‐gestational age infants: A prospective randomised study

“…19 Polycythaemia in newborns may cause neurological complications, respiratory distress, myocardial dysfunction, renal vein thrombosis, hypoglycaemia, hypocalcaemia, thrombocytopenia and hyperbilirubinemia. 20 Although polycythaemia and hyperviscosity may also be encountered in healthy term infants after DCC, these effects have been reported to usually be mild and to not lead to any complications. 1,18 However, questions about DCC in infants with intra-uterine growth restriction, in LGA infants and in infants of mothers with active or passive smoking habits remain unanswered.…”

Frequency and risk factors of fetal malnutrition among liveborn singleton term neonates using a computerised perinatal database, 2000–2006

“…Unlike other studies, we observed 0.6% of term singleton LGA neonates as having FM. The malnourished term AGA and LGA neonates might be under the similar metabolic and haematological risks as the term singleton SGA neonates in early postnatal, adolescent and adult life 26–30 …”

“…The malnourished term AGA and LGA neonates might be under the similar metabolic and haematological risks as the term singleton SGA neonates in early postnatal, adolescent and adult life. [26][27][28][29][30] The number of subjects in the studies investigating neonates with FM in the literature is limited to around 400-500. 15,[18][19][20] Therefore, the higher number of subjects evaluated is one of the advantages of the current study evaluated 11.741 liveborn term singleton neonates born in our hospital over the course of five and a half years.…”

Diabetes Gestacional: Serão os Atuais Critérios de Diagnóstico Mais Vantajosos?

“…A hiperbilirrubinémia poderá relacionar--se com a policitémia secundária ao aumento da eritropoiese, também associada a RN LIG. 35 Além dos outcomes mencionados, os critérios DGS -IADPSG não estiveram associados a redução dos partos pré-termo, partos instrumentados, complicações hipertensivas e malformações do RN.…”