Polycythemia in Neonates: Incidence, Maternal and Fetal Risk Factors, Clinical Profile, Umbilical Cord Blood Haematocrit as a Screening Test for Polycythemia

Objectives- This study was aimed to determine the incidence of polycythemia in newborns delivered from December, 2014 to December, 2015, to study fetal and maternal risk factors, clinical profile and to determine the role of umbilical cord blood haematocrit as a screening test at birth for neonatal polycythemia. Methods- In this descriptive analytical study, umbilical cord blood haematocrit was determined, detailed history was taken, anthropometry and examination was done. Venous haematocrit was determined at 2 hours in neonates having cord haematocrit 55 % and these neonates were followed up. Venous haematocrit was determined at 24 hours in neonates whose venous haematocrit at 2 hours was 65 % (polycythemic neonates). Other laboratory tests were done as and when indicated. Symptomatic polycythemic infants were subjected to interventions accordingly. Results- The incidence of neonatal polycythemia was 1.18 %, higher in preterm neonates, LGA babies, in babies of diabetic mothers, 66.7 % of the polycythemic babies were symptomatic, Plethora was the commonest followed by refusal to feeds, jitteriness, jaundice, lethargy, cyanosis and dyspnoea. Hypoglycaemia and hyperbilirubinemia were the commonest laboratory abnormalities detected, followed by thrombocytopenia.5 (31.25 %) of the 16 (66.67 %) symptomatic polycythemic neonates required intervention in our study. Conclusion- Umbilical cord blood haematocrit was found to be a reliable screening test for polycythemia in neonates. A cut off value of umbilical cord blood haematocrit 60 % should be followed up. Long term follow-up of these polycythemic neonates is required to know the late complications.