Nuchal cord as a cause of neonatal anemia

Nuchal cord was documented in 437 neonates consecutively admitted to the newborn nursery at The University of Texas Medical Branch Hospital, Galveston. The prevalence of anemia in the nuchal cord group (venous hemoglobin level of less than 13.2 g/dL or hematocrit of less than 39.2%) was compared with that in a control group. None of the controls was anemic. Five of 27 neonates with tight nuchal cord and four of 30 with loose nuchal cord were anemic. Anemia in the tight nuchal cord group was usually observed early, and in three infants was manifest by hypotension, necessitating transfusion. Anemia associated with loose nuchal cord occurred later and was asymptomatic. This study emphasizes the increased risk of anemia associated with nuchal cord and demonstrates the need for hemoglobin and hematocrit determinations in neonates with this obstetrical complication.