Cerebrospinal fluid xanthochromia in newborns is related to maternal labor before delivery.
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.
Nigrovic
Lise E
LE
Division of Emergency Medicine, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA. lise.nigrovic@childrens.harvard.edu
Trivedi
Michelle
M
Edlow
Jonathan A
JA
Neuman
Mark I
MI
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
D015415:Biomarkers