Polycythemia in small for gestational age infants

Abstract

Neonatal polycythemia and related disorders were studied in 23 full-term infants small for gestational age (SGA), 23 full-term (F-AGA), and 18 preterm infants of birth weights appropriate for gestational age (P-AGA). SGA infants had significantly higher hemoglobin, hematocrit, erythrocyte count, and fetal hemoglobin concentration values than other babies. Half of the SGA infants were polycythemic (venous hematocrit greater than 60 per cent). Four of them, all male infants, had important clinical problems including respiratory difficulties, priapism, hypoglycemia, and hypocalcemia. SGA infants also demonstrated a significant decrease in reticulocyte count after the first postnatal day. In all infants, capillary hematocrits were consistently higher than venous hematocrits. All male SGA babies should have hematocrit determinations shortly after birth and be observed closely for the development of clinical complications, particularly if polycythemic.