Evaluation of Neonatal Polycythemia in Terms of Gestational Age, Hematocrit, and Platelet Levels

Year 2022, , 495 - 500, 30.11.2022

Rumeysa Yalçınkaya , Ayşegül Zenciroğlu

https://doi.org/10.12956/tchd.1016684

Cited By: 2

Abstract

Objective: The main concern in neonatal polycythemia is complication development due to hyperviscosity. We aimed
to compare symptoms, clinical and laboratory features, and organ dysfunctions of polycythemic newborns with respect
to gestational age, hematocrit (hct) levels and presence of thrombocytopenia.

Material and Methods: Between January 2013 and December 2016, all hospitalized newborns with a gestational
age of ≥ 34 weeks were retrospectively evaluated and those with a venous hct value exceeding 65% were included.
Exclusion criteria were infections, metabolic diseases and congenital anomalies. Newborns were grouped and compared
according to hct values (65–69.9% vs. ≥70%), gestational age (late preterm vs. term) and thrombocytopenia (present/
absent).

Results: Polycythemia incidence was 7.7% in the study group. The most common symptoms were hypoglycemia
and hyperbilirubinemia, while 35.1% of newborns were asymptomatic. Hypoglycemia, hypocalcemia, and plethora
were significantly more frequent in the severe polycythemia (hct ≥70%) group than in the moderate polycythemia (hct
between 65–69.9%) group (p = 0.027, p = 0.014, p < 0.001, respectively). Hyperbilirubinemia was more common in
late preterm babies than term babies (p = 0.014). Feeding difficulty, convulsion, hypoglycemia, hypocalcemia and liver
function test abnormalities were significantly more common in newborns with thrombocytopenia than those without (p
= 0.002, p = 0.004, p < 0.001, p = 0.022, p = 0.043, respectively).

Conclusion: It should be kept in mind that more than one-third of polycythemic newborns may be asymptomatic. While
the most common symptoms were hypoglycemia and hyperbilirubinemia, liver function tests may also be adversely
affected.

Keywords

Hematocrit, hyperviscosity, late preterm, newborn, thrombocytopenia

Yenidoğan Polisitemisinin Gebelik Yaşı, Hematokrit ve Trombosit Düzeyleri Açısından Değerlendirilmesi

Abstract

Amaç: Yenidoğan polisitemisinde esas sorun hiperviskoziteye bağlı komplikasyonlardır. Bu çalışmanın amacı polisitemik yenidoğanların semptomlarını, klinik ve laboratuvar özelliklerini ve organ işlev bozukluklarını; gestasyonel yaş, hematokrit (hct) düzeyleri ve trombositopeni varlığı açısından değerlendirmektir.

Gereç ve Yöntemler: Ocak 2013 ile Aralık 2016 tarihleri arasında, hastanede yatan gestasyonel yaşı≥34 hafta olan tüm yenidoğanlar geriye dönük olarak değerlendirildi. Venöz hct değerleri %65’in üzerinde olan yenidoğanlar çalışmaya dahil edildi. Enfeksiyon, metabolik hastalık ve konjenital anomalileri olan yenidoğanlar çalışma dışı bırakıldı. Yenidoğanlar hct değerlerine (Orta derece polisitemi [%65-69] ve Şiddetli derece polisitemi [≥%70]), gestasyonel yaşa göre (geç preterm/ term) ve trombositopeni durumuna (var/yok) göre gruplandırıldı ve karşılaştırıldı.

Bulgular: Çalışma grubunda polisitemi insidansı %7.7 olarak saptandı. En sık görülen semptomlar hipoglisemi ve hiperbilirubinemi iken, yenidoğanların %35.1’i asemptomatikti. Hipoglisemi, hipokalsemi ve pletore şiddetli polisitemi grubunda orta polisitemi grubuna göre anlamlı olarak daha sıktı (sırasıyla p= 0.027, p= 0.014, p< 0.001). Hiperbilirubinemi, geç preterm bebeklerde term olanlara göre daha sıktı (p= 0.014). Trombositopenisi olan yenidoğanlarda, beslenme güçlüğü, konvülziyon, hipoglisemi, karaciğer fonksiyon testleri anormallikleri, trombositopenik olmayanlara göre anlamlı olarak daha fazlaydı (sırasıyla p= 0.002, p = 0.004, p < 0.001, p = 0.022, p = 0.043).

Sonuç: Polisitemik yenidoğanların asemptomatik olabileceği akılda tutulmalıdır. En sık görülen semptomlar hipoglisemi ve hiperbilirubinemi iken, karaciğer onksiyon testleri de polisitemik yenidoğanlarda etkilenebilir. 

Keywords

hematokrit, hiperviskozite, geç preterm, yenidoğan, trombositopeni

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