Anemia of prematurity natural history, complications and prognosis

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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

Common complications of anemia of prematurity include poor growth, apnea, and cardiovascular instability. The prognosis of anemia of prematurity is good with treatment

Natural History

• In preterm infants, anemia gets worsened due to other illness related to prematurity and blood loss during phlebotomy
• Premature infants develop abnormal clinical signs and symptoms depending on the hemoglobin levels
• Some infants can be asymptomatic or develop mild symptoms that require little or no therapy
• Others develop severe signs and symptoms that require treatment with blood transfusion and erythropoietin
• If left untreated, anemia of prematurity leads to cardiovascular instability

Complications

Anemia of prematurity can develop following complications:

• Poor growth
• Apnea
• Cardiovascular instability

Complications that can develop as a result of the treatment of anemia of prematurity are

• Infections
• Allergic reactions
• Iron overload
• Fluid overload
• Electrolyte imbalance
• Calcium disturbance
• Immune mediated adverse reactions
  • Acute hemolytic reaction
  • Febrile non-hemolytic reaction
  • Immunosuppression
  • Graft versus host disease
  • Transfusion related acute lung injury
• Transfusion of toxic substances present in the blood
  • Lead
  • Mercury
  • Plasticizers
• Necrotizing enterocolitis
• Bronchopulmonary dysplasia

Prognosis

• The prognosis of anemia of prematurity is good with prompt diagnosis and early treatment
• Milder cases usually resolve spontaneously with age
• Without adequate treatment, anemia of prematurity will result in serious complications