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Causes of Anemia Less Than 7 Days of Age

Journal of the Korean Pediatric Society 1994;37(12):1725-1731.
Published online December 15, 1994.
Causes of Anemia Less Than 7 Days of Age
Man Seong Ko, Jina Sohn, Jae Wook Ko, Soon Wha Kim, Don Hee Ahn
Department of Pediatrics, National Medical Center, Seoul, Korea
생후 7일 이내 신생아 빈혈의 원인적 고찰
고만성, 손진아, 고만성, 김순화, 안돈희
국립의료원 소아과
Abstract
Purpose
: Within a few days from birth, newborn infants are under conitions of normal physiologic changes. During this period, the certain newborn infants are confronted with a severe life-threatenling hematologic problems such as anemia. Therefore, prompt diagnosis of anemia and accurate identification of underlying causes would rather be essential to provide appropriate menagement.
Methods
: Eighty three newborn infants who met the criteria of anemia were cellected. The accepted blood was venous blood only. They were all hospitalized less than 7 days old in the nursery of National Medical Center from January, 1992 to June, 1993. The other laboratory tests-reticulocyte count, peaked total bilirubin, Coombs' test, hemohlobin F, and erythropoietinwere checked.
Results
: 1) Twenty three of 80 cases( 29%), showed reticulocyte count above five percent. Ten of 23 cases were premature. Of these causes, ABO incompatibility was four cases(22%), fetomaternal transfusion was one case, and Rh incompatibility, cephalohematoma, intracranial hemorrhage, pneumonia were one case, respectively. 2) Among 54 of 83 cases, the total bilirubin was above 10.0mg/dl. Twenty cases were caused by hemorrhage(38%), 16 of those were cephalohematoma. ABO incompatbility and Rh incompatibility was 8 and 1 case, respectively. Sepsis, cytomegalovirus infection, and congenital leukemia was one case, respectively. 3) Twenty six of 83 cases were checked the serum erythropoietin level, and the mean value was 22. 8?3.3mU/ml in fullterm; in contrast, 14.9?.1mU/ml in premature infants. 4) Among the causes of anemia, the hemorrhage consist of 23 of 62 fullterm cases. Of these, the fetomaternal transfusion was four cases of anemia, the hemorrhage consist of 23 of 62 fullterm cases. Of these, the fetomaternal transfusion was four cases and cephalohematoma was 19 cases, ABO incompatibility was nine cases; while Rh incompatibility was one case. Finally, infection was four cases in this study. As a whole the causes of anemia were as follows in the order of frequency; hemorrhage, hemolysis, and infection.
Conclusion
: Among the causes of anemia in less than 7 days of age, hemorrhage was the most common and more common than infection.
Key Words: Anemia, Newborn


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