Causes of neonatal polycythemia

Erythrocyte transfusion (passive)

Delayed clamping of the umbilical cord

Uncontrolled or precipitous delivery

Intrapartum hypoxia

Twin-twin transfusion (occurs in 10 to 15% of monochorionic twin pregnancies)

Maternal-fetal transfusion (rare)

Increased intrauterine erythropoiesis (active)

Placental insufficiency

Maternal hypoxemia due to cardiac or pulmonary disorders

Infant risk factors

Large for gestational age
Maternal diabetes mellitus
Beckwith-Wiedemann syndrome
Endocrine abnormalities (congenital adrenal hyperplasia, hypothyroidism, hyperthyroidism)
Chromosomal anomalies (trisomy 21, 18, and 13)

Courtesy of Joseph Garcia-Prats.

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