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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

Authors

  • 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

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