Pathophysiology of Anemia During the Neonatal Period, Including Anemia of Prematurity

This review summarizes the current thinking about the causes of anemia universally experienced by preterm infants in the early postnatal weeks. In addition to describing developmentally determined physiologic processes contributing to anemia of prematurity, this review discusses clinically important nonphysiologic contributors to anemia experienced by preterm infants during the neonatal period. Chief among these and an important contributor to the need for red blood cell transfusions is the heavy laboratory phlebotomy loss sustained shortly after birth, when neonatal cardiorespiratory illness is most severe. Understanding and recognizing the physiologic and nonphysiologic processes contributing to anemia encountered in early postnatal life is important in knowing which treatment and prevention modalities are likely to be most effective in different clinical situations. The evaluation of rare and uncommon acquired and genetic causes of anemia in newborns are not covered in this review.