Polycythemia in Yekatit 12 Hospital Neonatal Intensive Care Unit, Addis Ababa, Ethiopia,

Abstract

Background: Polycythemia is defined as an elevated hemoglobin concentration or
hematocrit that is greater than two standard deviations above the normal value for gestational
and postnatal age (1). The primary concern with polycythemia is related to hyper viscosity and
its associated complications Blood viscosity increases exponentially as the Hct level rises above
42%. This associated hyperviscosity is thought to contribute to the symptom complex observed in
approximately one half of infants with polycythemia.
Objective and Patients: The objective of this study was to describe prominent features of
associated with neonatal polycythemia in newborns admitted to the neonatology unit of Yekatit
12 Hospital for the period of July 2006 up to December 2009.
Results: There were 1741 neonatal admissions to Yekatit 12 hospital from July 2006 up to
December 2009 and out of these there were 115 cases of Polycythemia which makes the
prevalence of Polycythemia 6.5% in the neonatal unit.. Even though most were delivered by
SVD the risk of polycythemia was high in C/S group. Majority of the cases presented at the age
of less than 24hours with a normal Apgar score.. Seventy eight (73 %) of the cases had a
Hematocrit of >70% and 37 (27%) of the cases were symptomatic. The common presenting
symptoms were respiratory distress, cyanosis and poor feeding. Forty two (36.5%) had
complications including hyperbilirubinemia, necrotising enterocolitis and seizure. One hundred
and nine (94.5%) were discharged home with successful treatment with either fluid or partial
exchange transfusion; however, there were 5 deaths: 3 females and 2 males; three of them
were preterm while two were term but small for gestational age (SGA). Among these deaths
three were low birth weights (LBW) while two were very low birth weights (VLBW). (The
incidence of polycythemia in the last 6 months of the study period was zero).
Conclusion: Polycythemia is fairly a common problem in neonatal period and to avoid serious
complications early diagnosis and appropriate interventions are recommended, moreover this
study could be used as a base line data for future study of polycythemia in neonates in Ethiopian
settings