Polycythemia (neonathology)

Neonatal polycythemia is defined as central venous hematocrit > 0.65. However, even with a hematocrit > 0.70, only a small proportion of newborns have clinical signs of hyperviscosity. The clinical picture includes lethargy, hypotonia, hyperbilirubinemia and hypoglycemia. Polycythemia can also be involved in the development of seizures, stroke, renal vein thrombosis, and necrotizing enterocolitis.

Causes of polycythemia of the newborn:
 * fetal growth restriction (FGR, IUGR);
 * maternal hypertension;
 * maternal diabetes;
 * chromosomal defects: trisomy 21, 18,13;
 * twin-to-twin transfusion;
 * delayed interrupion of the umbilical cord;
 * endocrine disorders: thyrotoxicosis icosis, congenital adrenal hyperplasia (CAH).

Treatment is controversial and probably unnecessary in neonates with mild symptoms (eg, borderline glycemia, impaired peripheral blood flow). Treatment is indicated in neonates with a hematocrit > 0.65 and symptoms with a potentially serious prognosis (eg, refractory hypoglycemia, neurological symptoms). A partial exchange transfusion is performed with a crystalloid solution (e.g. physiological saline solution) with a target hematocrit of 0.55.

Related articles

 * Anemia (pediatrics) • Trombocytopenia of newborn