Neonatal polycythemia: incidence and associated factors

Background: The chief concern in neonatal polycythemia (NPC) is the development of complications due to hyper viscosity. We aimed to study risk factors, clinical features, laboratory investigations, management and outcome of neonates with polycythemia at our set up. Methods: A prospective study was conducted in the frame of January 2021 to January 2022 at tertiary care institute in Ahmedabad, all neonates with gestational age ≥34 weeks were evaluated and those with venous hematocrit more than 65% or hemoglobin exceeding 22 mg/dl were included in the study. The clinical features and laboratory parameters were noted. Asymptomatic neonates or neonates with mild polycythemia were observed for rising hematocrit or development of symptoms whereas symptomatic neonates or neonates with moderate and severe polycythemia were subjected to interventions as needed. Results: Incidence of polycythemia in this study was 11.18 per 100 neonates. The most common symptoms observed were jaundice in 68 (43.3%) neonates, followed by lethargy in 33 (21%). Other symptoms observed were refusal to feed (18.4%), respiratory distress (11.4%), jitteriness (6.3%), decrees urine output (2.5%), and cyanosis (1.2%). The noted laboratory abnormalities were hyperbilirubinemia (43.3%) followed by thrombocytopenia (40.1%), hypoglycemia (28%) and hypocalcemia (4.4%). The 35.6% neonates require hydration and 22.5% of neonates required partial exchange transfusion, rest were managed conservatively. Conclusions: the study suggested that polycythemia is a frequent problem among neonates. More than one third of them can be asymptomatic indicating the importance of assessing the associates’ risk factors.