NUCLEATED RED BLOOD
CELLS IN POLYCYTHEMIC INFANTS
Mandel D, Littner Y, Mimouni FB, Dollberg S
The Department of Neonatology, Lis Maternity
Hospital, Tel Aviv Sourasky Medical Center, and the Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
Objective: To evaluate whether the absolute nucleated red
blood cell (RBC) count is elevated in term, appropriate-for-gestational-age
(AGA) polycythemic infants.
Methods: We compared
absolute nucleated RBC counts taken during the first 12 hours of life in
term, AGA infants, one group with neonatal polycythemia which underwent
partial dilutional exchange transfusion (N=29), and the other of control,
non-polycythemic infants (N=37).
Results: There were no differences between groups in
birth weight, gestational age, maternal age, gravidity, parity, maternal
analgesia during labor, 1- and 5-minute Apgar scores, and infant sex. The
hematocrit, RBC count, and absolute nucleated RBC count were significantly
higher (p<0.02) and the platelet count significantly lower (p<0.002)
in the polycythemia group than in the control group. There were no
significant differences in lymphocyte counts or WBC counts between the 2
groups. Spearman ranked correlation showed a significant relationship
between absolute nucleated RBC and hematocrit (r2 = 10.9%;
p=0.007). In backward stepwise regression analysis, taking into account
polycythemia, gestational age and the 1- or 5- minute Apgar scores as
independent variables and the absolute nucleated RBC count as the dependent
variable, only polycythemia was a predictor of increased absolute nucleated
RBC count (p=0.017)
Conclusion: At birth, when compared
with controls, term AGA polycythemic infants have increased indices of
active erythropoiesis.