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==[[Anemia of prematurity overview|Overview]]==


==[[Anemia of prematurity historical perspective|Historical Perspective]]==


'''Anemia of prematurity''' is a normochromic, normocytic [[anemia]] commonly seen in [[premature birth|premature]] infants cared for in the [[neonatal intensive care unit]]. 
==[[Anemia of prematurity classification|Classification]]==
==Pathophysiology==
 
The total volume of blood in premature infants is approximately 100ml/kg of body weight--approximately 5 ounces for a 1.5kg infant.  Blood sampling done for laboratory testing in the first days of life can easily remove enough blood to produce anemia.  As anemia develops, the amount of oxygen delivered by the hemoglobin in the blood to the body organs declines.  Normally this stimulates increased production of [[erythropoietin]] (EPO), but this response is diminished in premature infants.  While the reason for this decreased response is not fully understood, it is theorized that there is a genetically timed switch from [[liver|hepatic]] production of EPO, which occurs in-utero, to [[kidney|renal]] production.  Since hepatic production is stimulated by lower levels of oxygen delivery (reflecting the lower levels present in the fetus) and since the red blood cells are carrying higher amounts of oxygen after birth, the level of red blood cells itself must drop significantly before EPO production will begin in premature infants who have not yet switched from hepatic to renal EPO production.  This level may be as low as a [[hemoglobin]] of 6.5g/dL, corresponding to an [[hematocrit]] of approximately 19.
==[[Anemia of prematurity pathophysiology|Pathophysiology]]==
 
==[[Anemia of prematurity causes|Causes]]==
 
==[[Anemia of prematurity differential diagnosis|Differentiating Anemia of prematurity from other Diseases]]==
 
==[[Anemia of prematurity epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Anemia of prematurity risk factors|Risk Factors]]==
 
==[[Anemia of prematurity natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[Anemia of prematurity history and symptoms| History and Symptoms]] | [[Anemia of prematurity physical examination | Physical Examination]] |[[Anemia of prematurity laboratory findings|Laboratory Findings]] | [[Anemia of prematurity ultrasound|Ultrasound]] | [[Anemia of prematurity other imaging findings|Other Imaging Findings]] | [[Anemia of prematurity other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
The best treatment is prevention by minimizing the amount of blood drawn from the infant.  Modern technology, including non-invasive pulse-oximetry, development of laboratory equipment that can use very small blood volume samples, and in-dwelling monitors that can measure blood-gas parameters without removing any blood have helped delay or even eliminate anemia of prematurity in some infants.
[[Anemia of prematurity medical therapy|Medical Therapy]] | [[Anemia of prematurity primary prevention|Primary Prevention]] | [[Anemia of prematurity secondary prevention|Secondary Prevention]] | [[Anemia of prematurity cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Anemia of prematurity future or investigational therapies|Future or Investigational Therapies]]
Recombinant EPO may be given to premature infants to stimulate red blood cell production.  Premature infants are equally responsive to EPO as term infants.  However, the response to EPO typically takes up to 2 weeks.  To date, studies of EPO use in premature infants have had mixed results.  It is likely that only a carefully selected subpopulation of infants may benefit from its use.
==Outcome==
Anemia of prematurity may be tolerated in the otherwise healthy premature infant without complications and will eventually spontaneously resolve when EPO production resumes.  However, hemoglobin levels < 10g/dL may be associated with decreased growth, evidence of compensatory increased cardio-respiratory response ([[tachycardia]] and [[hyperventilation|tachypnea]]), and an increase in [[apnea]].  Treatment of symptomatic anemia of prematurity is with blood transfusion.
==References==
{{cite book
  | last = Spitzer
  | first = Alan
  | title = Intensive Care of the Fetus & Neonate
  | publisher = Elsevier
  | date = 2005
  | pages = 1286
  | doi =
  | isbn = 1-56053-512-1 }}
 


==Case Studies==
[[Anemia of prematurity case study one|Case#1]]


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Latest revision as of 16:34, 28 August 2020

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Anemia of prematurity from other Diseases

Epidemiology and Demographics

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Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

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Medical Therapy

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Asra Firdous, M.B.B.S.[2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Anemia of prematurity from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination |Laboratory Findings | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case#1


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