title: Adrenal haemorrhage in term neonates: a retrospective study from the period 2001-2013.
abstract: OBJECTIVE
  To assess the incidence, risk factors and clinical presentations of neonatal adrenal haemorrhage (NAH) in uncomplicated, singleton and term deliveries.
  
  
  METHODS
  A retrospective analysis of 26,416 term neonates delivered between 2001 and 2013, and screened with abdominal ultrasonography.
  
  
  RESULTS
  Of the 26,416 neonates, 74 (0.28%) displayed NAH; the male/female ratio was 1.55:1. Vaginal delivery was significantly more frequent than caesarean section among them (71 versus 3; 95.9% versus 4.1%). Unilateral bleeding occurred on the right side in 36 (48.7%), and on the left in 34 (45.9%), without a significant difference; bilateral haematomas were found in four cases (5.4%). The most common risk factors were macrosomia (16, 21.6%) and fetal acidaemia (23, 31%), while four (5.4%) neonates exhibited pathological acidaemia. Clinical presentations included jaundice in 37 (50%), anaemia in six (8.1%) and an adrenal insufficiency in only one (1.3%) case. In three cases, neuroblastoma was diagnosed.
  
  
  CONCLUSIONS
  Vaginal delivery, macrosomia and fetal acidaemia are the most important risk factors for NAH. The adrenal glands on both sides were similarly involved. In the healthy neonates with NAH, the clinical presentations were mild, with spontaneous regression. Differentiation of NAH from tumours is of considerable importance.
authors.affiliation: a Department of Obstetrics and Gynaecology and.
authors.forename: Zita
authors.initials: Z
authors.lastname: Gyurkovits
authors.affiliation: b Department of Paediatrics , University of Szeged , Szeged , Hungary.
authors.forename: Ágnes
authors.initials: Á
authors.lastname: Maróti
authors.affiliation: a Department of Obstetrics and Gynaecology and.
authors.forename: Lóránd
authors.initials: L
authors.lastname: Rénes
authors.affiliation: a Department of Obstetrics and Gynaecology and.
authors.forename: Gábor
authors.initials: G
authors.lastname: Németh
authors.affiliation: a Department of Obstetrics and Gynaecology and.
authors.forename: Attila
authors.initials: A
authors.lastname: Pál
authors.affiliation: a Department of Obstetrics and Gynaecology and.
authors.forename: Hajnalka
authors.initials: H
authors.lastname: Orvos
mesh_terms: D000138:Acidosis / Q000150:complications; D000307:Adrenal Gland Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000473:pathology; D001724:Birth Weight; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications; D005865:Gestational Age; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography
keywords: Adrenal haemorrhage; neonate; ultrasonographic screening