Neonatal anemia can be caused by blood loss, destruction of red blood cells, or insufficient production of red blood cells. Symptoms include pale skin, abnormal heart rhythms, and poor nutrition. Treatment depends on the cause and severity, with severe cases requiring blood transfusions. Premature babies can have anemia prevented by limiting blood sampling for laboratory tests.
Anemia is a condition in which blood does not have enough red blood cells or hemoglobin or is low in volume. Neonatal anemia is defined as anemia that occurs in a baby who is less than 28 days old. In premature infants, anemia is often present at birth; in healthy full-term newborns, anemia may not be apparent until one to two weeks after birth. Several factors can cause or contribute to the development of neonatal anemia. These causes are classified into three types: blood loss, destruction of red blood cells, and insufficient production of red blood cells, with the most common cause of anemia in newborns being blood loss.
Blood loss can result from trauma to the placenta or umbilical cord before or during delivery or from internal bleeding. In premature babies, blood loss and anemia are common after blood samples have been taken for laboratory testing. This occurs because a premature newborn has such a small blood volume that it decreases significantly after a blood test. Blood loss that causes anemia can also occur if a large amount of blood is transferred from the fetus to the placenta. This can occur if the newborn is positioned over the placenta during or after birth, because gravity causes blood to move into the placenta.
Destruction of red blood cells or insufficient production of red blood cells can occur due to an inherited red blood cell disorder. Such disorders include hereditary spherocytosis, which increases the rate of red blood cell destruction, and infection-induced bone marrow suppression, which decreases the rate at which new red blood cells are produced. Insufficient red blood cell production can also result from iron deficiency, but this type of anemia is relatively rare during the neonatal period. Anemia caused by an increased rate of red blood cell destruction can result from blood group incompatibility between mother and child, infections, or inherited blood disorders.
Neonatal anemia can cause a wide range of symptoms, depending on the cause and severity of the anemia. Symptoms can include pale skin, abnormal heart rhythms or pulses, increased need for supplemental oxygen, difficulty sleeping, lethargy, low blood pressure, and poor nutrition. Additionally, infants with anemia are at risk of jaundice, an enlarged spleen, and metabolic acidosis, a serious disease that can be fatal.
Treatment of neonatal anemia also depends on the cause and severity. A severe case of anemia may require a blood transfusion, and a mild case of transient anemia may require no treatment. In the case of premature babies, anemia can be prevented, or risks reduced, by limiting blood sampling for laboratory tests. When the cause of neonatal anemia is an inherited blood disorder, the underlying cause of the anemia must also be treated.
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