Anemia of prematurity overview: Difference between revisions
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{{Anemia of prematurity}} | {{Anemia of prematurity}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{Asra}} | ||
==Overview== | ==Overview== | ||
'''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''' is a normochromic, normocytic [[anemia]] commonly seen in [[premature birth|premature]] infants cared for in the[[neonatal intensive care unit]]. | ||
==Pathophysiology== | |||
[[Anemia of prematurity]] is multifactorial in origin. [[Phlebotomy]] is the major contributing factor. Other important factors are decreased [[erythropoietin]] production, increased [[erythropoietin]] [[metabolism]], deficient [[iron]] stores, and decreased [[RBC]] lifespan. | |||
==Causes== | |||
[[Anemia of prematurity]] may be caused by a combination of [[blood loss]], decreased [[red blood cells| RBC]] production, and shortened lifespan of [[red blood cells| RBC]]. | |||
==Epidemiology and Demographics== | |||
[[Anemia of prematurity]] is a common problem in [[NICU]]. It usually affects [[preterm]] and [[low birth weight]] [[infants]] born before 32-weeks of [[gestation]]. It affects male and female [[infants]] equally with no racial predilection. | |||
==Risk factors== | |||
Common [[risk factors]] in the development of [[anemia of prematurity]] are [[preterm birth]], [[low birth weight]], and excess [[blood loss]] during [[phlebotomy]]. | |||
==Natural History, Complications, and Prognosis== | |||
Common [[complication|complications]] of [[anemia of prematurity]] include [[poor growth]], [[apnea]], and [[cardiovascular instability]]. The [[prognosis]] of [[anemia of prematurity]] is good with [[treatment]] | |||
==Diagnosis== | |||
===History and Symptoms=== | |||
Majority of patients with [[anemia of prematurity]] are either [[asymptomatic]] or develop vague and non-specific [[symptom|symptoms]]. They usually present with [[pallor]] and [[lethargy]]. Decreased activity, [[breathing difficulties]], [[feeding difficulties]], and difficulty in gaining [[weight]] are common [[symptom|symptoms]]. Less common [[symptom|symptoms]] are [[tachycardia]], [[heart murmurs]], and [[metabolic acidosis]]. | |||
===Physical Examination=== | |||
Patients with [[anemia of prematurity]] usually appear [[pale]] and [[lethargic]]. [[Physical examination]] of patients with [[anemia of prematurity]] is usually remarkable for [[pallor]], decreased activity, and [[poor growth]. | |||
===Laboratory Findings=== | |||
[[Laboratory findings]] consistent with the [[diagnosis]] of [[anemia of prematuriy]] reduced [[hemoglobin]], [[hematocrit]], and [[reticulocyte count]] in the [[blood]]. | |||
===Ultrasound=== | |||
===Other Imaging Findings=== | |||
===Other Diagnostic Studies=== | |||
==Treatment== | |||
===Medical Therapy=== | |||
[[PRBC]] [[transfusion]] is the mainstay in the [[treatment]] of [[anemia of prematurity]]. [[Treatment]] of [[infant|infants]] with [[anemia of prematurity]] depends on the severity of [[symptom|symptoms]]. [[Blood transfusion]] and recombinant [[erythropoietin]] [[therapy]] are used to treat [[symptomatic]] [[infant|infants]]. | |||
===Primary Prevention=== | |||
Effective measures for the [[primary prevention]] of [[anemia of prematurity]] include limiting [[blood loss]] during [[phlebotomy]], [[cord blood]] sampling for the [[laboratory investigations]], and improving [[placental transfusion]]. | |||
==References== | ==References== | ||
Revision as of 15:49, 27 July 2020
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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
Anemia of prematurity is a normochromic, normocytic anemia commonly seen in premature infants cared for in theneonatal intensive care unit.
Pathophysiology
Anemia of prematurity is multifactorial in origin. Phlebotomy is the major contributing factor. Other important factors are decreased erythropoietin production, increased erythropoietin metabolism, deficient iron stores, and decreased RBC lifespan.
Causes
Anemia of prematurity may be caused by a combination of blood loss, decreased RBC production, and shortened lifespan of RBC.
Epidemiology and Demographics
Anemia of prematurity is a common problem in NICU. It usually affects preterm and low birth weight infants born before 32-weeks of gestation. It affects male and female infants equally with no racial predilection.
Risk factors
Common risk factors in the development of anemia of prematurity are preterm birth, low birth weight, and excess blood loss during phlebotomy.
Natural History, Complications, and Prognosis
Common complications of anemia of prematurity include poor growth, apnea, and cardiovascular instability. The prognosis of anemia of prematurity is good with treatment
Diagnosis
History and Symptoms
Majority of patients with anemia of prematurity are either asymptomatic or develop vague and non-specific symptoms. They usually present with pallor and lethargy. Decreased activity, breathing difficulties, feeding difficulties, and difficulty in gaining weight are common symptoms. Less common symptoms are tachycardia, heart murmurs, and metabolic acidosis.
Physical Examination
Patients with anemia of prematurity usually appear pale and lethargic. Physical examination of patients with anemia of prematurity is usually remarkable for pallor, decreased activity, and [[poor growth].
Laboratory Findings
Laboratory findings consistent with the diagnosis of anemia of prematuriy reduced hemoglobin, hematocrit, and reticulocyte count in the blood.
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
PRBC transfusion is the mainstay in the treatment of anemia of prematurity. Treatment of infants with anemia of prematurity depends on the severity of symptoms. Blood transfusion and recombinant erythropoietin therapy are used to treat symptomatic infants.
Primary Prevention
Effective measures for the primary prevention of anemia of prematurity include limiting blood loss during phlebotomy, cord blood sampling for the laboratory investigations, and improving placental transfusion.