All issues > Volume 29(5); 1986

Original Article

J Korean Pediatr Soc. 1986;29(5):525-534. Published online May 31, 1986.

Clinical Study on Anemia in Neonatal Period.

Jin Young Lee¹, Hong Kun Kim¹, Woo Gil Lee¹, Soo Jee Moon¹, Hahng Lee¹, Keun Soo Lee¹

¹Department of Pediatrics, College of Medicine, Hanyang University, Seoul，Korea

Abstract

Neonatal period is marked with constantly changing hematologic process due to a number of physiologic and pathologic factors, and with risk of underdiagnosis or misdiagnosis of anemia of various causes. Therefore, prompt diagnosis of anemia and accurate identification of its underlying causes would be essential to arrive at the appropriate management and to avoid occasional serious complications. 104 full term newborns with birth weight over 2,500 gm who met the criteria of neonatal anemia were selected among total 1,011 infants hospitalized during the first 4 weeks of life for various reasons on the pediatric ward of Hanyang University Hospital during the period of three years from March 1, 1982 to February 28, 1985. These anemic full term newborns were studied as to the clinical presentation, the laboratory . findings including hemograms, the types of anemia, and their underlying causes. The summary of the study and the observation is as follows: 1) Among the 1,011 newborns hospitalized for various reasons during the three year period, 104 infants met the criteria of neonatal anemia, indicating 10.3% frequency for anemia for hospitalized, newborns 2) As to the location of delivery for the study population of the 104 anemic newborns hospitalized, J6 infants were born originally at Hanyang University Hospital and discharged from the newborn nursery; 95 infants(91.3%) at other hospitals; and 3 infants from home delivery. 3) As to the clinical diagnosis at the time of admission, 47 out of 104 infants (45.2%) were admitted for neonatal jaundice; 32 infants(30.8^) for infections; and only 6 infants (5.8%) for blood dyscrasia. 4) Among the 34 infants with significant anemia with hemoglobin values below 10 gm/dl, 17 cases(50%) fell into the age group between 22 to 28 days after birth 5) Among the 33 infants with reticulocytosis with reticulocyte count over 5%, 25 infants (75.公%) fell into the age group under 7 days after birth, and, as to the cause of anemia, 15 cases (45.5%) among these infants had isoimmune hemolytic anemia due to ABO incompatibility. 6) Among the 47 infants with hyperbilirubinemia, 20 infants(42.6%) were found to have isoimmune hemolytic anemia due to ABO incompatibility, and 11 cases(23.2%) with infections. 7) Among the 104 infants in the study population, infection was the most common cause of anemia with 49 cases(45%) ； non-infectious hemolysis in 21 cases(19.3%)； and hemorrhage in 19 cases(17.4%). While anemia due to infections occurred evenly throughout the four weeks of life, non-infectious hemolytic anemia and anemia due to blood loss or hemorrhage occurred mostly within the first week of life. The results of the study and the observation indicate that neonatal anemia is most commonly due to hemolysis ineluding infections(64.3%); secondly due to hemorrhage (17.4%) ；and lastly due to marrow failure (0.9%). Anemia in the neonatal period could be due to various causes, and differs in time for presentation according to the causes. Therefore, it could be concluded that appropriate management of anemia and prevention of its complications demand a unique perspective in efficient establishment of prompt diagnosis of anemia and accurate identification of its underlying cause in newborn infants.

Keywords :Anemia in neonatal period.