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Am J Perinatol 2019; 36(14): 1510-1513
DOI: 10.1055/s-0039-1678556
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Methemoglobinemia Associated with Late-Onset Neonatal Sepsis: A Single-Center Experience

Ingrid Anne Mandy Schierz
1   Neonatal Intensive Care Unit, AOUP “P. Giaccone,” Department of Sciences for Health Promotion and Mother and Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
,
Giuseppa Pinello
1   Neonatal Intensive Care Unit, AOUP “P. Giaccone,” Department of Sciences for Health Promotion and Mother and Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
,
Ettore Piro
1   Neonatal Intensive Care Unit, AOUP “P. Giaccone,” Department of Sciences for Health Promotion and Mother and Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
,
Mario Giuffrè
1   Neonatal Intensive Care Unit, AOUP “P. Giaccone,” Department of Sciences for Health Promotion and Mother and Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
,
Giovanni Corsello
1   Neonatal Intensive Care Unit, AOUP “P. Giaccone,” Department of Sciences for Health Promotion and Mother and Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
› Author Affiliations
Funding None.
Further Information

Publication History

23 October 2018

26 December 2018

Publication Date:
01 February 2019 (online)

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Abstract

Objective Methemoglobinemia (MetHb) is a rare congenital or acquired cause of infantile cyanosis. We examined the role of MetHb in a neonatal intensive care unit (NICU).

Study Design A retrospective observational study was conducted reviewing blood gas analyses of hospitalized newborns over a 2-year period. MetHb-positive patients (MetHb >1.8%) were matched with a control group for gestational age, weight, disease, and illness severity at admission. Maternal, neonatal, clinical, and laboratory parameters were collected and analyzed in both groups.

Results MetHb incidence was 6%. The mean MetHb in the case group was 7.2%, and the first positive samples were observed at a mean of 22 days of life, 6 days prior to clinical or culture-proven sepsis. We identified low maternal age (31 vs. 34 years; p = 0.038), sepsis (90 vs. 45%; p = 0.022), and protracted parenteral nutrition (46 vs. 23 days; p = 0.013) as risk factors for MetHb, and early minimal enteral feeding as protective factor (12th vs. 9th day; p = 0.038).

Conclusion MetHb has a high occurrence in NICU and can be a helpful prognostic indicator of an infectious process. Understanding and prompt identification of MetHb can allow pediatricians to implement a life-saving therapy.

Keywords

observational study - cyanosis - anemia - hypoxia - newborn