Nonphysiological anaemia of prematurity

Area of Science:

• Neonatology
• Pediatric Hematology
• Physiology

Background:

• Anemia of prematurity is a common condition in preterm infants.
• Clinical manifestations of anemia in preterm infants are often linked to hemoglobin concentration and oxygen affinity.
• Fetal hemoglobin's high oxygen affinity contributes to anemia's clinical impact in neonates.

Purpose of the Study:

• To compare clinical and hematological findings at the nadir of anemia in preterm infants.
• To investigate the relationship between 'available oxygen' and clinical features of anemia.
• To develop a predictive formula for 'available oxygen' in preterm infants.

Main Methods:

• Study included 95 preterm infants.
• Clinical and hematological data were collected at the nadir of anemia.
• Correlation analysis was performed between hemoglobin concentration, oxygen affinity, and clinical signs.

Main Results:

• 53% of infants born before 32 weeks' gestational age exhibited clinical signs of anemia.
• Clinical features included tachycardia, tachypnoea, dyspnoea, feeding difficulties, diminished activity, and pallor.
• 'Available oxygen' correlated better with clinical features than hemoglobin concentration alone.

Conclusions:

• A formula was developed to predict 'available oxygen' using hemoglobin concentration and post-conceptual age.
• This formula obviates the need for direct measurement of hemoglobin-oxygen affinity.
• High hemoglobin-oxygen affinity is a significant factor in the clinical presentation of anemia in preterm infants.