Polycythaemia among term newborns: Incidence, risk factors and complications: Descriptive study in a teaching hospital in Sri Lanka

Background: Polycythaemia in the newborn is defined as either venous haematocrit above 65% or haemoglobin levels at or above 22 g/dL.  
Objectives: To detect the incidence, risk factors and complications of neonatal polycythaemia in a Sri Lankan cohort.
Method: This descriptive cross-sectional study was conducted at the Sri Jayewardenepura Teaching Hospital from November 2021 to June 2022. All neonates more than 37 weeks of gestation were included. To evaluate the maternal and neonatal variables, a comparative analysis was done between polycythaemic and non-polycythaemic groups.
Results: According to the haemoglobin cut-off threshold, 22 (17.5%) neonates had polycythemia and 104 (82.5%) had Hb levels below 22 g/dL. In this study, no participant had severe polycythaemia, 19 (15.1%) had mild polycythaemia, and 3 (2.4%) had moderate polycythaemia. Of the sample, 52 (41.3%) were born by normal vaginal delivery and 74 (58.7%) by caesarean section. Regarding management, 11 (8.7%) newborns required enteral feeding adjustment and 9 (7.1%) required partial exchange transfusions.
Conclusions: Incidence of polycythaemia in this study was 17.5%. Neonatal polycythaemia was significantly associated with the delivery method (p=0.019). However, none of the maternal variables were significantly associated statistically with the development of neonatal polycythaemia.