Circumcision bleeding complications: neonatal intensive care infants compared to those in the normal newborn nursery.

PURPOSE: To determine if a significant difference exists in the bleeding complications following circumcision in neonates admitted to neonatal intensive care unit (NICU) versus the normal newborn nursery (NNN).

MATERIALS AND

METHODS

Observational cohort study of 260 infants undergoing circumcision with Gomco clamp. Vitamin K was given to neonates at delivery. Demographic data, procedural characteristics, bleeding complications, and interventions were recorded. The bleeding rates of the two groups were compared using chi square.

RESULTS

NICU neonates experienced increased bleeding complications versus NNN neonates (22% vs. 9.6%, p = .029). No differences were found regarding gestational age at delivery, age at circumcision, and birth weight. Neonates with circumcision performed at ≥5 days of life experienced increased rates of bleeding complications versus those performed at ≤4 days (28% vs. 10.3%, p = .023). All neonates with circumcision performed ≥5 days of life were initially admitted to the NICU.

CONCLUSION

NICU neonates had increased rate of bleeding complications following circumcision when compared to the NNN neonates. There was an increased rate of bleeding complications in neonates who undergo circumcision at ≥5 days of life. Further research may help to determine if redosing of vitamin K or variations in the circumcision procedure are necessary for circumcision at >4 days of life.