title: Cerebrospinal fluid xanthochromia in newborns is related to maternal labor before delivery.
abstract: OBJECTIVE
  The purpose of this work was to investigate whether xanthochromia in newborns is related to maternal labor before delivery.
  
  
  METHODS
  We reviewed the medical charts of all of the infants < or = 30 days of age who had a lumbar puncture performed in a single pediatric emergency department between 2003 and 2005. Xanthochromia was detected by the hospital laboratory using the qualitative visual inspection method. We used logistic regression to determine the relationship between maternal labor before birth and the presence of cerebrospinal fluid xanthochromia, adjusting for factors known to be associated with xanthochromia.
  
  
  RESULTS
  Of the 478 newborns who had a lumbar puncture performed during the study period, 134 (28%) had xanthochromia. Of the 449 infants with delivery method recorded in the medical chart, 332 (74%) were born via vaginal delivery, 24 (5%) via cesarean section after maternal labor, and 93 (21%) via cesarean section without maternal labor. After excluding patients with hyperbilirubinemia (total bilirubin > or = 15 mg/dL) and adjusting for factors known to be associated with xanthochromia (cerebrospinal fluid red blood cells > or = 20,000 cells per mL and cerebrospinal fluid protein > or = 150 mg/dL), infants born after maternal labor had a higher rate of cerebrospinal fluid xanthochromia than infants born without any labor.
  
  
  CONCLUSIONS
  Xanthochromia is a common finding in the cerebrospinal fluid of newborns and is associated with maternal labor preceding delivery.
authors.affiliation: Division of Emergency Medicine, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA. lise.nigrovic@childrens.harvard.edu
authors.forename: Lise E
authors.initials: LE
authors.lastname: Nigrovic
authors.forename: Michelle
authors.initials: M
authors.lastname: Trivedi
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Edlow
authors.forename: Mark I
authors.initials: MI
authors.lastname: Neuman
mesh_terms: D015415:Biomarkers / Q000134:cerebrospinal fluid; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000175:diagnosis; D007231:Infant, Newborn / Q000134:cerebrospinal fluid*; D007743:Labor, Obstetric; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D012880:Skin Pigmentation
chemical_list: D015415:Biomarkers