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Reduced haemoglobin levels in infants presenting with apparent life-threatening events--a retrospective investigation
C F Poets1, M P Samuels, C A Wardrop
1Department of Paediatric Clinical Physiology, National Heart & Lung Institute, London, UK.
Insights
This study found a significant link between anemia and apparent life-threatening events in infants. Many infants experiencing these events had lower than expected hemoglobin levels, suggesting anemia may contribute to their cause.
Area of Science:
- Pediatrics
- Hematology
Background:
- Anemia is linked to increased apnoeic pause frequency and cyanotic breath-holding spells.
- Apparent life-threatening events (ALTEs) require thorough investigation in infants.
Purpose of the Study:
- To investigate the relationship between anemia and ALTEs in term infants.
- To determine if low hemoglobin levels are prevalent in infants experiencing ALTEs.
Main Methods:
- Retrospective analysis of 72 term infants referred for ALTE assessment.
- Review of venous red blood cell counts and hemoglobin (Hb) levels for 41 infants.
- Comparison of infant Hb levels against normal literature data.
Main Results:
- Median age at ALTE was 2.0 months.
- 34 out of 41 infants had Hb levels below the normal mean.
- A statistically significant proportion of infants (p < 0.001) exhibited anemia.
Conclusions:
- Anemia may play a role in the pathophysiology of ALTEs in some infants.
- Further research is warranted to elucidate the causal link between anemia and ALTEs.
Abstract:
Anaemia has been shown to be associated with an increased apnoeic pause frequency and with cyanotic breath-holding spells. In this study, the relationship between anaemia and apparent life-threatening events was retrospectively investigated in 72 term infants referred for assessment and home monitoring following an apparent life-threatening event. For 41 infants (25 male, 16 female; 38 Caucasian, three Asian) a venous red blood cell count was available. Their median age at the time of the apparent life-threatening event was 2.0 (0.6-6.7) months. The Hb levels in these 41 infants were plotted against normal data from the literature. Thirty-four infants had Hb levels below the mean, whilst six infants had values above the corresponding normal mean; the one remaining infant had a Hb value identical to the normal mean. Significantly more infants than expected had Hb levels below the mean (p less than 0.001, binomial test). Anaemia may have played a role in the pathophysiology leading to life-threatening events in some of the infants investigated in this study.