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Published on: March 14, 2013
[Neurologic follow-up of polycythemic newborn infants]
Insights
Neonatal polycythemia can cause symptoms like plethora and tremors. Exchange transfusion may reduce symptoms but doesn't prevent neurological issues and carries risks, especially in asymptomatic infants.
Area of Science:
- Neonatalogy
- Pediatric Neurology
Context:
- Neonatal polycythemia, defined by venous hematocrit >65%, affects newborns.
- Study conducted at Instituto Nacional de Perinatologia.
- Follow-up of infants during their first year of life.
Purpose:
- To investigate neurologic findings in neonates with polycythemia.
- To evaluate the efficacy and risks of exchange transfusion.
Summary:
- Seventy-five neonates with polycythemia were studied.
- Frequent signs included plethora, respiratory distress, cyanosis, and tremors.
- Eight neonates (11% of symptomatic) developed transient neurologic impairments.
- Associated findings: hypoglycemia, hyperbilirubinemia, necrotizing enterocolitis, meconium aspiration.
Impact:
- Neurologic findings were less frequent than in other studies.
- Exchange transfusion reduces polycythemia symptoms but not neurologic sequelae.
- Exchange transfusion is not recommended for asymptomatic neonates due to complication risks like enterocolitis.
- A simple treatment scheme is proposed.
Abstract:
Seventy five newborn infants with neonatal polycythemia diagnosis (venous hematocrit levels greater than 65% were studied). They were born in the Instituto Nacional de Perinatologia and follow through their first year of life searching for neurologic findings. The more frequent signs related to polycythemia in this group were: presence of plethora, respiratory distress, cyanosis and tremors; the associated findings were hypoglycemia, hyperbilirubinemia, necrotizing enterocolitis and meconium aspiratum. Sixty eight of the seventy five neonates developed symptomatology and seven didn't. The eight neonates who developed neurologic transient impairments belonged to the symptomatic group in a 0.11 proportion. We concluded that the number of babies with neurologic findings in our sample was small in comparison with other reference studies; we also found that the exchange transfusion is not a preventive measure for neurologic sequel, but it is useful to diminish the symptomatology caused by polycythemia; besides we don't recommend this procedure in asymptomatic babies because the complication risks as the enterocolitis. We propose a simple treatment scheme.
