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Relationship of Early Anemia with Neurodevelopment and Brain Injury in Very Low Birth Weight Preterm Infants-A
Xiaotong Wang1, Jiajia Jing1, Saijun Huang2
1Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
Insights
Early anemia in very-low-birth-weight preterm infants is linked to poorer neurodevelopment, particularly in behavioral abilities. This study found no association with brain injury in these vulnerable infants.
Area of Science:
- Neonatal Medicine
- Developmental Neuroscience
- Pediatric Hematology
Background:
- Anemia in older children is linked to developmental issues.
- The impact of early anemia on neonatal preterm infants remains unclear.
- Very-low-birth-weight (VLBW) preterm infants are a vulnerable population.
Purpose of the Study:
- To investigate the relationship between early anemia and neurodevelopment in VLBW preterm infants.
- To assess the association between early anemia and brain injury in this population.
- To determine if early anemia affects neurodevelopment within the neonatal period.
Main Methods:
- Prospective cohort study of 110 VLBW preterm infants.
- Early anemia defined as hemoglobin ≤145 g/L within the first week of life.
- Neurodevelopment assessed using Neonatal Behavioral Neurological Assessments (NBNA) and brain injury by cranial ultrasound at 1 month corrected age.
Main Results:
- Infants with early anemia showed lower scores in behavioral ability on the NBNA test compared to controls.
- Early anemia was negatively associated with overall NBNA scores and specifically with behavioral ability scores.
- No significant association was found between early anemia and brain injury.
Conclusions:
- Early anemia in VLBW preterm infants is negatively correlated with neurodevelopment.
- Behavioral ability is particularly affected by early anemia in this population.
- Further research may explore interventions to mitigate these neurodevelopmental effects.
Abstract:
Anemia is associated with neurodevelopmental delays and brain injury in infants and toddlers, but whether early anemia has a similar effect in neonatal preterm infants is largely unknown. Thus, this study aimed to determine the relationship of early anemia with neurodevelopment and brain injury in very-low-birth-weight (VLBW) preterm infants within the neonatal period. A prospective cohort study including 110 VLBW preterm infants was conducted in Southern China from 2016 to 2018. All participants were followed from birth to 1 month corrected age. Early anemia is defined as hemoglobin of ≤145 g/L within the first week after birth. The non-anemic group (control group, N = 55) was 1:1 matched with the early anemia group (N = 55) according to birth weight and gestational age. Neurodevelopment at 1 month corrected age and brain injury within 1 month corrected age were measured by neonatal behavioral neurological assessments (NBNA) and cranial ultrasound, respectively. Compared to the control group, the early anemia group had a lower score in behavioral ability in the NBNA test [11 (10-12) vs. 10 (9.5-11), p = 0.033]. Early anemia was negatively associated with the NBNA total score (β= -0.680, 95% CI: -1.300, -0.059), especially with the behavioral ability score (β= -0.504, 95% CI: -0.941, -0.067) after adjusting for the confounders. However, no association between early anemia and brain injury was observed. In conclusion, in VLBW preterm infants, early anemia is negatively correlated with neurodevelopment, especially with behavioral ability.
