title: Polycythemia in neonatal intensive care unit, risk factors, symptoms, pattern, and management controversy.
abstract: BACKGROUND
  Polycythemia (PC) is defined as venous hematocrit (hct) ≥65%.( ) Its incidence is high among certain risk factors (RFs). Its management is controversy.
  
  
  OBJECTIVE
  TO DETERMINE: (1) The incidence of PC in our neonatal intensive care unit (NICU). (2) Most common RF, symptoms, and laboratory abnormalities (LA) associated with PC and their effect on the length of hospital stay (LOS). (3) Whether noninvasive interventions are effective in reducing hct. (4) Hct pattern of PC neonates.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  NICU at a maternity and children hospital.
  
  
  METHODS
  Records review of all neonates from March 2011 to August 2013. Inclusions criteria were: (1) Venous hct ≥65%. (2) Neonates born in our institution. (3) Early umbilical cord clamping. (4) Gestational age ≥34 weeks.
  
  
  METHODS
  Chi-square and multiple regression analysis.
  
  
  RESULTS
  One hundred and one PC neonates were eligible. Incidence of PC in our NICU is 14.5%. The most common RF, symptoms, and LA were: Small for gestational age, jaundice and hypoglycemia respectively. Tachypnea (  P - 0.04) and oliguria (P - 0.03) significantly prolonged LOS. Noninvasive interventions or observation could not reduce the hct significantly (P - 0.24). The hcts mean peaked maximally at a mean of 2.8 h of age.
  
  
  CONCLUSIONS
  PC incidence in our NICU is higher than the reported incidence in healthy newborns. Most of the PC neonates were either symptomatic or having LA. Noninvasive interventions or observation were not effective in reducing hct in polycythemic neonates. Hct in both healthy and PC neonates peaked at the same pattern.
authors.affiliation: Department of Pediatric, Neonatal Intensive Care Unit, Aziziah Maternity and Children Hospital, Jeddah, Kingdom of Saudi Arabia.
authors.forename: Tariq Rushdi Mohieldeen
authors.initials: TR
authors.lastname: Alsafadi
authors.affiliation: Department of Pediatric, Neonatal Intensive Care Unit, Aziziah Maternity and Children Hospital, Jeddah, Kingdom of Saudi Arabia.
authors.forename: Saad Manzoor
authors.initials: SM
authors.lastname: Hashmi
authors.affiliation: Department of Pediatric, Neonatal Intensive Care Unit, Aziziah Maternity and Children Hospital, Jeddah, Kingdom of Saudi Arabia.
authors.forename: Hala Atta
authors.initials: HA
authors.lastname: Youssef
authors.affiliation: Department of Pediatric, Neonatal Intensive Care Unit, Aziziah Maternity and Children Hospital, Jeddah, Kingdom of Saudi Arabia.
authors.forename: Awatif Khogali
authors.initials: AK
authors.lastname: Suliman
authors.affiliation: Department of Pediatric, Neonatal Intensive Care Unit, Aziziah Maternity and Children Hospital, Jeddah, Kingdom of Saudi Arabia.
authors.forename: Haifa'A Mansour
authors.initials: HM
authors.lastname: Abbas
authors.affiliation: Department of Pediatric, Neonatal Intensive Care Unit, Aziziah Maternity and Children Hospital, Jeddah, Kingdom of Saudi Arabia.
authors.forename: Mohammad Hakem
authors.initials: MH
authors.lastname: Albaloushi
keywords: Hematocrit; length of hospital stay; neonatal intensive care unit; neonate; noninvasive; observation; overhydration; pattern; polycythemia