Polycythemia in Neonatal Nursery in Duhok: Incidence, Risk Factors and Leading Causes of Admission

Dr. Akrem M. Atrushi

Volume : IV, Issue : XI, November - 2015

Polycythemia in Neonatal Nursery in Duhok: Incidence, Risk Factors and Leading Causes of Admission

Dr. Akrem M. Atrushi

Abstract :

 Background: Polycythemia is defined as venous hematocrit more than 65%. Its incidence is 1.5– 4% live births. Polycythemia is more common in newborns of IUGR, perinatal asphyxia, trisomy 21,twin pregnancy, delayed cord clamping and congenital adrenal hyperplasia. Aim: To find the incidence of neonatal polycythemia among neonates admitted to the neonatal nursery, the predisposing factors and the leading causes of admission associated with polycythemia. Patients and Methods: A retrospective study included all neonates admitted to the neonatal nursery at a maternity hospital in Duhok from June to December 2015. The diagnosis of polycythemia is made when venous hematocrit = or >65%. The data about all patients included : age, sex, birth weight, gestational age, weight for gestational age, APGAR score, Oxygen saturation SPO2. The patients were sent for chest X ray, serum bilirubin, complete blood count and blood culture as indicated by clinical picture .These data were analysed using SPSS 19 to find the clinical significance when P<0.05. Results: Among 149 patients 21.47% (n=32) had polycythemia. Most common age is in the first two days of life in both groups of patients with and without polycythemia P=0.278. Sex distribution of patients showed predominance of male sex among both groups P=0.11. The most common birth weight of polycythemic patients 53.12% (n=17) is< 2500 grams and in non polycythemic patients 49.38% (n=80) is 2500– 4000 grams. Among 56.25%(n=18) of polycythemic and 64.19%(n=104) of non polcythemic patients were full term P=0.256. In polycythemic patients, 43.75%(n=14) and in non polycythemic 49.38%(n=80) were small–for–gestational age P=0.269.In 6.25%(n=2) of polcythemic and 7.5% (n=12) of nonpolycythemic had low oxygen saturation P=0.585.In 34.37%(n=11) of polycythemic and 33.9%(n=55) of non polycythemic there was respiratory distress P=0.557. Low apgar score was present in 12.5%(n=4) of polycythemic and 13.6%(n=22) of non polycythemic P=0.566. The leading causes of admission in polycythemic patients were Respiratory distress syndrome 37.5%(n=12), transient tachypnea of newborn 24.87%(n=7) and hyperbilirubinemia 15.62%(n=5). Conclusion: The incidence of polycythemia is higher than in other studies. Male sex and age of first two days predominated in polycythemic neonates. Prematurity, small–for gestational age, low SpO2, respiratory distress and hyperbilirubinemia have higher incidence than other studies. Respiratory distress syndrome, transient tachypnea of newborn and hyperbilirubinemia were the three leading causes of admission of polycythemic patients.