Neonatal hyperviscosity association with lower achievement and IQ scores at school age.

A longitudinal study was conducted to determine whether the early neurologic and motor impairment observed in children with neonatal polycythemia and hyperviscosity persisted into school age. Forty-nine children who had neonatal polycythemia and hyperviscosity were evaluated at a mean age of 7 years. Of these, 21 (group 1) received a partial plasma exchange transfusion, whereas 28 (group 2) received symptomatic care.

Outcome of very-low-birth-weight infants: are populations of neonates inherently different after antenatal versus neonatal referral?

Postnatal transfer of high-risk infants to a neonatal intensive care unit has been an accepted medical practice for more than two decades. More recently, antepartum maternal referral for the smallest infants has been recommended to reduce infant mortality, morbidity, and long-term handicaps. The limited data available to compare in utero and postnatal transfer suggest that maternal risk factors may also influence antenatal referral.

Outcome of very-low-birth-weight infants: does antepartum versus neonatal referral have a better impact on mortality, morbidity, or long-term outcome?

To evaluate the effect of aggressive intrapartum and early neonatal resuscitation on perinatal mortality, neonatal morbidity, and long-term outcome, we evaluated two groups of low-birth-weight infants who received different intrapartum and early neonatal care. One group of infants was delivered at a university-based regional perinatal center offering both high-risk obstetric and tertiary neonatal care. The second population consisted of infants from five community hospitals with level I nurseries.

Gastrointestinal injury in polycythemic term infants.

Necrotizing enterocolitis is uncommon among term infants. In this group, necrotizing enterocolitis has been associated with two risk factors: polycythemia and umbilical catheterization. During a randomized trial of partial plasma exchange transfusion for treatment of polycythemia, an increased risk of gastrointestinal problems was noted.

Neonatal hyperviscosity: randomized study of effect of partial plasma exchange transfusion on long-term outcome.

The use of partial plasma exchange transfusion in newborns with polycythemia and hyperviscosity was evaluated. Ninety-three infants with polycythemia and hyperviscosity were randomly assigned to receive either partial plasma exchange transfusion or symptomatic treatment; the infants were matched with control infants without polycythemia. Neonatal course and outcome at 1 and 2 years were evaluated for each of the three groups.