Prediction of Peak Neonatal Hematocrit


AbstractBackground: The cord blood hematocrit(Hct) is an important index of neonatal well-being, and it's estimation is necessary in the early detection of neonatal polycythemia and consequently the prevention of it's unwanted sequels. Objective: To predict peak levels of neonatal hematocrit.Subjects & Methods: The study was conducted on 202 live born in three different maternity hospitals in Baghdad, during the period(1st of February 2005 to 30th of May 2005). All neonates were delivered at term, their birth weight ranging in-between 2.5-4.6Kg. We excluded dysmorphic, congenitally anomalous neonates, infants of diabetic mothers or intrauterine growth retardation, infants of smoking mothers, neonates with meconium-stained amniotic fluid,. All mothers were healthy, non-anemic with uncomplicated pregnancies or emergency cesarean section deliveries. Case group was divided into; Group one which included vaginal delivered(VD) infants, group two included elective cesarean section(CS) delivered infants. Umbilical cord was clamped early with no stripping, umbilical vein blood and dorsal hand vein blood at 2-4 hours of age was collected. Samples of blood were tested for hematocrit and hemoglobin. Results: Mean birth weight of the study group was 3.345(+/-0.475) Kg, The males: females were 102:100 and male newborns were significantly heavier than female newborns(P value <0.001).Repeated CS was the commonest cause of elective cesarean section.The mean birth weight and median Apgar scoring at one and five minutes did not differ significantly in the two groups while there was a significant difference in gestational age between group one and two(P value <0.001) by approximately one week. Mean cord hematocrit and 2-hour hematocrit were significantly lower in (CS) group than (VD) group (P value <0.001). The rise in 2-hour hematocrit is significantly different in the two groups, 10.3(+/-4.8) in group one and 7.97(+/-5.4) in group two(P value <0.03). While sex, birth weight, gestational age or Apgar scoring had no significant influence on cord Hct. Conclusion: Mode of delivery is an important factor to be considered in the proper prediction of peak neonatal hematocrit levels. Key words: Cord blood hematocrit, mode of delivery, peak neonatal hematocrit.