Published online October 8, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. e1212-e1216 (doi:10.1542/10.1542/peds.2007-0681)
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ARTICLE

Cerebrospinal Fluid Xanthochromia in Newborns Is Related to Maternal Labor Before Delivery

Lise E. Nigrovic, MD, MPHa,b, Michelle Trivedi, MSc, Jonathan A. Edlow, MDb,d and Mark I. Neuman, MD, MPHa,b

a Division of Emergency Medicine, Children's Hospital Boston, Boston, Massachusetts
c University of Massachusetts Medical School, Worcester, Massachusetts
d Division of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
b Harvard Medical School, Boston, Massachusetts

OBJECTIVE. The purpose of this work was to investigate whether xanthochromia in newborns is related to maternal labor before delivery.

METHODS. We reviewed the medical charts of all of the infants ≤30 days of age who had a lumbar puncture performed in a single pediatric emergency department between 2003 and 2005. Xanthochromia was detected by the hospital laboratory using the qualitative visual inspection method. We used logistic regression to determine the relationship between maternal labor before birth and the presence of cerebrospinal fluid xanthochromia, adjusting for factors known to be associated with xanthochromia.

RESULTS. Of the 478 newborns who had a lumbar puncture performed during the study period, 134 (28%) had xanthochromia. Of the 449 infants with delivery method recorded in the medical chart, 332 (74%) were born via vaginal delivery, 24 (5%) via cesarean section after maternal labor, and 93 (21%) via cesarean section without maternal labor. After excluding patients with hyperbilirubinemia (total bilirubin ≥15 mg/dL) and adjusting for factors known to be associated with xanthochromia (cerebrospinal fluid red blood cells ≥20000 cells per mL and cerebrospinal fluid protein ≥150 mg/dL), infants born after maternal labor had a higher rate of cerebrospinal fluid xanthochromia than infants born without any labor.

CONCLUSIONS. Xanthochromia is a common finding in the cerebrospinal fluid of newborns and is associated with maternal labor preceding delivery.

Key Words: xanthochromia • cerebrospinal fluid • delivery method

Abbreviations: CSF—cerebrospinal fluid • LP—lumbar puncture • RBC—red blood cell • HSV—herpes simplex virus • PCR—polymerase chain reaction

Accepted Apr 12, 2007.


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