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Neonatal hyperviscosity: I. Incidence.

F H Wirth, K E Goldberg, L O Lubchenco

    Pediatrics
    |June 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

    Newborn infants at high altitude can experience polycythemia (high hematocrit) and hyperviscosity (thick blood). Infants small for gestational age were at highest risk, impacting blood flow and oxygen delivery.

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    Area of Science:

    • Neonatal Medicine
    • Pediatric Hematology
    • High-Altitude Physiology

    Background:

    • Neonatal polycythemia and hyperviscosity are concerns, particularly at high altitudes.
    • Accurate hematocrit measurement in newborns is crucial for assessing these conditions.

    Purpose of the Study:

    • To determine the incidence of polycythemia and hyperviscosity in newborns at high altitude.
    • To investigate the relationship between capillary and venous hematocrits.
    • To explore the influence of birth weight and gestational age on these conditions.

    Main Methods:

    • Capillary hematocrits were measured in 790 infants within four hours of birth at 1,061 m altitude.
    • Venous hematocrit and blood viscosity were determined when capillary hematocrit was ≥7%.

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  • Infants were categorized by gestational age, birth weight, and polycythemia/hyperviscosity status.

    • Main Results:

    • Capillary hematocrits in the first hour were unreliable indicators of venous hematocrit.
    • Venous polycythemia (hematocrit ≥65%) occurred in 4% of infants.
    • Hyperviscosity occurred in 5% of infants; predictable at hematocrit ≥65%, but also seen between 60-64%.
    • Infants small for gestational age had the highest risk, followed by those large for gestational age. Term infants appropriate for gestational age had the highest absolute number with hyperviscosity.
    • Preterm infants <34 weeks gestation were unaffected.

    Conclusions:

    • High altitude may contribute to neonatal polycythemia and hyperviscosity.
    • Capillary heel stick measurements require careful interpretation in the early neonatal period.
    • Gestational age and birth weight are significant risk factors for neonatal hyperviscosity, with specific risks for SGA and LGA infants.