Anemia of prematurity (patient information)

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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 condition where red blood cell production is decreased due to reduced erythropoietin production. It is commonly seen in preterm infants admitted in the neonatal intensive care unit.

What are the symptoms of anemia of prematurity?

Symptoms of anemia of prematurity include one or more of the following:

• Pale skin
• Lethargy
• Decreased activity
• Difficulty breathing
• Rapid heart rate
• Poor weight gain
• Feeding difficulties

What causes anemia of prematurity?

• Preterm birth
• Blood loss during phlebotomy for laboratory investigations

Who is at highest risk?

• Premature infants
• Extremely low birth weight infants

Diagnosis

Blood tests show

• Low hemoglobin levels
• Low red blood cell count
• Low hematocrit levels
• Loe reticulocyte count

A peripheral blood smear shows normocytic, normochromic red blood cells with predominant red blood cell precursors

Treatment options

• Mild disease needs close monitoring and supportive care
• Infants with moderate to severe anemia require blood transfusion or erythropoietin therapy

Prevention

• Limit blood loss during phlebotomy
• Improve placental transfusion by following two methods
  • Delayed cord clamping
  • Umbilical cord milking

What to expect (Outlook/Prognosis)?

With prompt diagnosis and early treatment, symptoms resolve without any complications in infants with anemia of prematurity. If left untreated, anemia of prematurity leads to serious complications

Possible complications

Complications include:

• Poor growth
• Apnea
• Cardiovascular instability

Sources

• The National Library of Medicine http://www.nlm.nih.gov/medlineplus/.