2 - Anemia during the neonatal period

Abstract

The root causes of anemia during neonatal period are hemorrhage, hemolysis, and failure of red cell production. Hemorrhage, commonly known as blood loss, may occur during the prenatal, intranatal, or postnatal period. Prenatal blood loss may be transplacental, intraplacental, or retroplacental, or may be due to a twin-to-twin transfusion. Hemolytic anemia in the newborn is usually associated with unconjugated hyperbilirubinemia. The hemolytic process is often first detected as a result of the investigation of jaundice during the first week of life. The causes of hemolytic anemia in the newborn are congenital erythrocyte defects, hemoglobin defects, enzyme defects, and acquired erythrocyte defects. Anemia of prematurity is characterized by reduced bone marrow erythropoietic activity and low serum erythropoietin levels. It may be compounded by folic acid, vitamin E, and iron availability and frequent blood sampling. The low hemoglobin concentration is due to decreased red cell production, shorter red cell life span, and increased blood volume with growth. Recombinant human erythropoietin treats anemia of prematurity. It is a safe, inexpensive, and effective treatment in reducing the number of transfusions required.