Early anemia of preterm infants (guideline)

• Ekaterina N. Balashova
• Diana R. Sharafutdinova
• Marina V. Narogan
• Anna A. Puchkova
• Anna V. Degtyareva
• Olga I. Sapun
• Anna L. Karpova
• Olga A. Senkevich
• Anna R. Kirtbaya
• Andrey Yu. Ryndin
• Yuliya M. Golubtsova
• Oleg V. Ionov
• Victor V. Zubkov
• Dmitry N. Degtyarev

Abstract

The article presents the guideline of management of the newborns with early anemia of preterm infants: definition, etiology, diagnostics and treatment of this disease with evidence based practice, algorithm of management and health care quality criteria.

Keywords:anemia, preterm infants, transfusion, erythropoietin

REFERENCES

1. Colombatti R., Sainati L., Trevisanuto D. Anemia and transfusion in the neonate. Semin Fetal Neonatal Med. 2016; 21 (1): 2-9.

2. Sakharova E.S., Keshishian E.S., Alyamovskaya G.A. Anemia in premature babies. Pathogenesis, diagnosis, treatment and prevention. Meditsinskiy sovet [Medical Council]. 2015; (6): 10-7. DOI: https://doi.org/10.21518/2079-701X-2015-6-10-17 (in Russian)

3. Widness J.A. Pathophysiology of anemia during the neonatal period, including anemia of prematurity. Neoreviews. 2008; 9 (11): 520-5.

4. Luchtman-Jones L., Schwartz W.D. The blood and hematopoietic system. Edited by A.A. Fanaroff, R.J. Martin. Neonatal-Perinatal Medicine. Disorders of Fetus and Infant. 7^th ed. St Louis: Mosby, 2002: 1182-254.

5. Widness J.A. Pathophysiology, diagnosis, and prevention of neonatal anemia. Neoreviews. 2000; 1 (4): 61.

6. Papayan A.V., Zhukova L.Yu. Anemia in children: clinical practice guidelines. Saint Petersburg: Piter, 2001: 384 p. (Series "Modern Medicine"). ISBN 5-272-00364-0 (in Russian)

7. Dallman PR. Blood and blood-forming tissues. Eds by A. Rudolph. Pediatrics. 16^th ed. New York: Appleton-Century-Crofts, 1977: 1111.

8. Brown M.S., et al. Decreased response of plasma immunoreactive erythropoietin to "available oxygen" in anemia of prematurity. J Pediatr. 1984; 105 (5): 793-8.

9. New H.V., et al. Guidelines on transfusion for fetuses, neonates and older children. Br J Haematol. 2016; 175 (5): 784-828.

10. Von Lindern J.S., Lopriore E. Management and prevention of neonatal anemia: current evidence and guidelines. Expert Rev Hematol. 2014; 7 (2): 195-202.

11. de Freitas B.A.C., et al. Micronutrient supplementation adherence and influence on the prevalences of anemia and iron, zinc and vitamin a deficiencies in preemies with a corrected age of six months. Clinics. 2016; 71 (8): 440-8.

12. Aher S., Malwatkar K., Kadam S. Neonatal anemia. Semin Fetal Neonatal Med. 2008; 13 (4): 239-47.

13. Dallman PR. Anemia of prematurity. Annu Rev Med. 1981; 32: 143-60.

14. Girelli G., et al. Recommendations for transfusion therapy in neonatology. Blood Transfus. 2015; 13 (3): 484-97.

15. Bizzarro M.J., Colson E., Ehrenkranz R.A. Differential diagnosis and management of anemia in the newborn. Pediatr Clin North Am. 2004; 51: 1087-107.

16. Jopling J., et al. Reference ranges for hematocrit and blood hemoglobin concentration during the neonatal period: data from a multihospital health care system. Pediatrics. 2009; 123 (2): e333-7.

17. Obladen M., Sachsenweger M., Stahnke M. Blood sampling in very low birth weight infants receiving different levels of intensive care. Eur J Pediatr. 1988; 147 (4): 399-404.

18. Madsen L.P., et al. Impact of blood sampling in very preterm infants. Scand J Clin Lab Invest. 2000; 60 (2): 125-32.

19. Takahashi D., et al. Effect of transfusion on the venous blood lactate level in very low-birthweight infants. Pediatr Int. 2009; 51 (3): 321-5.

20. Dani C., et al. Effects of red blood cell transfusions during the first week of life on acid-base, glucose, and electrolytes in preterm neonates. Transfusion. 2008; 48 (11): 2302-7.

21. Nadeem M., Clarke A., Dempsey E.M. Day 1 serum lactate values in preterm infants less than 32 weeks gestation. Eur J Pediatr. 2010; 169 (6): 667-70.

22. Izraeli S., et al. Lactic acid as a predictor for erythrocyte transfusion in healthy preterm infants with anemia of prematurity. J Pediatr. 1993; 122 (4): 629-31.

23. Ross M.P., Christensen R.D., Rothstein G., Koenig J.M., Simmons M.A., Noble N.A., et al. A randomized trial to develop criteria for administering erythrocyte transfusions to anemic preterm infants 1 to 3 months of age. J Perinatol. 1989; 9 (3): 246-53.

24. Kanmaz H.G., et al. Effects of red cell transfusion on cardiac output and perfusion index in preterm infants. Early Hum Dev. 2013; 89 (9): 683-6.

25. Dallman M.D., et al. Changes in transfusion practice over time in the PICU. Pediatr Crit Care Med. 2013; 14 (9): 843-50.

26. Abdelghaffar S., et al. Red blood transfusion in preterm infants: changes in glucose, electrolytes and acid base balance. Asian J Transfus Sci. 2012; 6 (1): 36-41.

27. Wang M. Iron deficiency and other types of anemia in infants and children. Am Fam Physician. 2016; 93 (4): 270-8.

28. Joy R., et al. Early versus late enteral prophylactic iron supplementation in preterm very low birth weight infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2014; 99 (2): F105-9.

29. McCarthy E.K., Dempsey E.M., Kiely M.E. Iron supplementation in preterm and low-birth-weight infants: a systematic review of intervention studies. Nutr Rev. 2019; 77 (12): 865-77.

30. Schiza V., et al. Serum transferrin receptor, ferritin, and reticulocyte maturity indices during the first year of life in "large" preterm infants. Eur J Haematol. 2007; 79 (5): 439-46.

31. Lorenz L., et al. Reference ranges of reticulocyte haemoglobin content in preterm and term infants: a retrospective analysis. Neonatology. 2017; 111 (3): 189-94.

32. Diab Y.A., Wong E.C.C., Luban N.L.C. Massive transfusion in children and neonates. Br J Haematol. 2013; 161 (1): 15-26.

33. Sihler K.C., Napolitano L.M. Complications of massive transfusion. Chest. 2010; 137 (1): 209-20.

34. Order of the Ministry of Health of the Russian Federation dated 02.04.2013 No. 183n. "The rules of clinical use of donor blood and/or its components" (registered Russian Ministry of Justice, 2013). (in Russian)

35. MacDonald M.G., Ramasethu J.R.-B.K. Atlas of Procedures in Neonatology. 5th ed. Lippincott Williams and Wilkins, Wolter Kluwer, 2013: 429 p.

36. Mozzini C., et al. Ultrasound as first line step in anaemia diagnostics. Mediterr J Hematol Infect Dis. 2019; 11 (1): 1-10.

37. Singh Y., et al. International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Crit Care. 2020; 24 (1): 1-16.

38. Joshi S., Mulinge I., Kamat M. An extremely premature neonate with severe anemia. J Neonatal Surg. 2017; 6 (2): 33.

39. Mutlu M., et al. Adrenal hemorrhage in newborns: a retrospective study. World J Pediatr. 2011; 7 (4): 355-7.

40. Kluckow M., Evance N. Low superior vena cava flow and intraventricular haemorrhage in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2000; 82 (3): 188-94.

41. Papile L.A., et al. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978; 92 (4): 529-34.

42. Hintz S.R., et al. Interobserver reliability and accuracy of cranial ultrasound scanning interpretation in premature infants. J Pediatr. 2007; 150 (6): 592-6.

43. Toti M.S., et al. Adrenal hemorrhage in newborn: how, when and why- from case report to literature review. Ital J Pediatr. 2019; 45 (1): 1-8.

44. Azarow K., et al. Multidisciplinary evaluation of the distended abdomen in critically ill infants and children: the role of bedside sonography. Pediatr Surg Int. 1998; 13 (5-6): 355-9.

45. Sweet D.G., et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2019 Update. Neonatology. 2019; 115 (4): 432-50.

46. Von Lindern J.S., et al. Long-term outcome in relationship to neonatal transfusion volume in extremely premature infants: a comparative cohort study. BMC Pediatr. 2011; 11: 48.

47. Venkatesh V., et al. How we decide when a neonate needs a transfusion. Br J Haematol. 2013; 160 (4): 421-33.

48. Venkatesh V., et al. The safety and efficacy of red cell transfusions in neonates: a systematic review of randomized controlled trials. Br J Haematol. 2012; 158 (3): 370-85.

49. Whyte R., Kirpalani H. Low versus high haemoglobin concentration threshold for blood transfusion for preventing morbidity and mortality in very low birth weight infants. Cochrane Database Syst Rev. 2011; 11: CD000512.

50. Strauss R.G. Anaemia of prematurity: pathophysiology and treatment. Blood Rev. 2010; 24 (6): 221-5.

51. Nurse S.N. Red Blood Cell Transfusion for Neonates - Guidelines. 2020. January.

52. Wong H., et al. A comparison of high and standard blood transfusion volumes in premature infants. Acta Paediatr. 2005; 94 (5): 624-5.

53. Paul D.A., et al. Transfusion volume in infants with very low birth weight: a randomized trial of 10 versus 20 ml/kg. J Pediatr Hematol Oncol. 2002; 24 (1): 43-6.

54. Gibson B.E., Todd A., Roberts I., Pamphilon D., Rodeck C., Bolton-Maggs P., et al. Transfusion guidelines for neonates and older children. Br J Haematol. 2004; 124 (4): 433-53.

55. National comparative audit of the use of red cells in neonates and children 2010. In: National Comparative Audit Blood Transfusion. 2010.

56. Borisova I.P., Dmitriev A.V., Morshchakova E.F. Early anemia of premature newborns: prevention and treatment. Voprosy gematologii/onkologii i immunopatologii v pediatrii [Problems of Hematology/ Oncology and Immunopatology in Pediatrics]. 2004; 3 (1): 27-31. (in Russian)

57. Robinson S., et al. The administration of blood components: a British Society for Haematology Guideline. Transfus Med. 2018; 28 (1): 3-21.

58. 2020 Surveillance of Blood Transfusion. Blood Transfusion NICE Guideline [NG24]. London: National Institute for Health and Care Excellence (UK), 2015: 117 p.

59. Ohlsson A., Aher S.M. Early erythropoiesis-stimulating agents in preterm or low birth weight infants. Cochrane Database Syst Rev. 2020; 2: CD004863.

60. Ohls R.K., Christensen R.D., Kamath-Rayne B.D., Rosenberg A., Wiedmeier S.E., Roohi M., et al. A Randomized, masked, placebo-controlled study of darbepoetin alfa in preterm infants. Pediatrics. 2013; 132 (1): 119-27.

61. Christensen R.D., Lambert D.K., Richards D.S. Estimating the nucleated red blood cell "emergence time" in neonates. J Perinatol. 2014; 34: 116-9.

62. Warwood T.L., et al. Single-dose darbepoetin administration to anemic preterm neonates. J Perinatol. 2005; 25: 725-30.

63. Patel S., Ohls R.K. Darbepoetin administration in term and preterm neonates. Clin Perinatol. 2015; 42 (3): 557-66.

64. Sharafutdinova D.R., Balashova E.N., Ionov O.V., Kirtbaya A.R., Golubtsova Yu.M., Zubkov V.V., et al. The recombinant human erythropoietin therapy for extremely and very low birth weight infants. Voprosy gematologii/onkologii i immunopatologii v pediatrii [Problems of Hematology/Oncology and Immunopatology in Pediatrics]. 2019; 18 (2): 75-82. DOI: https://doi.org/10.24287/1726-1708-2019-18-2-75-82 (in Russian)

65. Meyer M.P., Meyer J.H., Commerford A., Hann F.M., Sive A.A., Moller G., et al. Recombinant human erythropoietin in the treatment of the anemia of prematurity: results of a double-blind, placebo-controlled study. Pediatrics. 1994; 93 (6): 918-23.

66. Donato H., et al. Effect of early versus late administration of human recombinant erythropoietin on transfusion requirements in premature infants: results of a randomized, placebo-controlled, multicenter trial. Pediatrics. 2000; 105 (5): 1066-72.

67. Ohls R.K., et al. The effect of erythropoietin on the transfusion requirements of preterm infants weighing 750 grams of less: a randomized, double-blind, placebo-controlled study. J Pediatr. 1997; 131 (5): 661-5.

68. Potapova V.E., Lysenko I.M., Zhuravleva L.N., Mekhovnikova D.A. Clinical evaluation of peculiarities of early anemia of prematurity and the effectiveness of its therapy in newborns of low gestational term. Okhrana materinstva i detstva [Protection of Motherhood and Childhood]. 2016; 2 (28): 16-9. (in Russian)

69. Ronnholm K.A.R., Siimes M.A. Haemoglobin concentration depends on protein intake in small preterm infants fed human milk. Arch Dis Child. 1985; 60 (2): 99-104.

70. Neonatal resuscitation and stabilization in delivery room. Methodological letter. Eds by E.N. Baybarina. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2020; 8 (1): 34-52. (in Russian)

71. Fogarty M., et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am J Obstet Gynecol. 2018; 218 (1): 1-18.

72. van Rheenen P.F., Gruschke S., Brabin B.J. Delayed umbilical cord clamping for reducing anaemia in low birthweight infants: Implications for developing countries. Ann Trop Paediatr. 2006; 26 (3): 157-67.

73. Widness J.A., et al. Reduction in red blood cell transfusions among preterm infants: results of a randomized trial with an in-line blood gas and chemistry monitor. Pediatrics. 2005; 115 (5): 1299-306.

74. Rosebraugh M.R., et al. A mathematical modeling approach to quantify the role of phlebotomy losses and need for transfusions in neonatal anemia. Transfusion. 2013; 53 (6): 1353-60.

75. Christensen R.D., Carroll P.D., Josephson C.D. Rvidence-based advances in transfusion practice in neonatal intensive care units. Neonatology. 2014; 106 (3): 245-53.

76. Brener Dik P.H., et al. Impact of the volume of blood collected by phlebotomy on transfusion requirements in preterm infants with birth weight of less than 1500 g. A quasi-experimental study. Arch Argent Pediatr. 2020; 118 (2): 109-16.

77. Jin H.X., et al. Early and late iron supplementation for low birth weight infants: a meta-analysis. Ital J Pediatr. 2015; 41 (1): 1-10.

78. Long H., et al. Benefits of Iron supplementation for low birth weight infants: a systematic review. BMC Pediatr. 2012; 12: 99.

79. Mills R.J., Davies M.W. Enteral iron supplementation in preterm and low birth weight infants. Cochrane Database Syst Rev. 2012; 5: CD005095.

80. Rao R., Georgieff M.K. Iron therapy for preterm infants. Clin Perinatol. 2009; 36 (1): 27-42.

81. MacQueen B.C., et al. Iron supplements for infants at risk for iron deficiency. Glob Pediatr Health. 2017; 4.

82. Moorthy D., et al. The impact of nutrition-specific and nutrition-sensitive interventions on hemoglobin concentrations and anemia: a metareview of systematic reviews. Adv Nutr. 2020; 11 (6): 1631-45.

83. Domellof M. Meeting the iron needs of low and very low birth weight infants. Ann Nutr Metab. 2017; 71 (3): 16-23.

84. Gomella T.L., Eyal F.G., Fayez B.-M. Gomella’s Neonatology. 8th ed. McGraw-Hill Education, 2020: 1441 p.

85. Zipursky A., Brown E.J., Watts J., Milner R., Rand C., Blanchette V.S., et al. Oral vitamin E supplementation for the prevention of anemia in premature infants: a controlled trial. Pediatrics. 1987; 79 (1): 61-8.

86. Fermanian J., Salmon D., Olive G., Zambrowski S., Rossier A., Caldera R. Comparaison en double aveugle de la vitamine e au placebo dans la prevention de l’anemie de l’enfant de faible poids de naissance a la 7e semaine de vie: essai therapeutique. Nouv Rev Fr Hematol Blood Cells. 1976; 16 (2): 245-54.

87. Brion L.P., Bell E.F., Raghuveer T.S. Vitamin E supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2003; 4: CD003665.

88. Narogan M.V., Lazareva V.V., Ryumina I.I., Vedikhina I.A. The value of folates for child health and development. Akusherstvo i ginekologiya [Obstetrics and Gynecology]. 2019; (8): 46-52. (in Russian)

89. Revakova T., Revak O., Vasilenkova A., Behulova D., Brucknerova I. Amount of folic acid in different types of nutrition used in the neonatal period. Bratisl Lek List. 2015; 116 (6): 349-53.

90. Jyothi S., et al. Red cell folate and plasma homocysteine in preterm infants. Neonatology. 2007; 92 (4): 264-8.

91. Oncel M.Y., et al. Is folic acid supplementation really necessary in preterm infants <32 weeks of gestation? J Pediatr Gastroenterol Nutr. 2014; 58 (2): 188-92.

92. Qakmak Qelik F., et al. Assessment of different folic acid supplementation doses for low-birth-weight infants. Turk Pediatri Ars. 2016; 51 (4): 210-6.

93. Program for optimizing the feeding of children of the first year of life in the Russian Federation. Moscow : FGAU "NMITs zdorov’ya detey" Minzdrava Rossii, 2019: 112 p. (in Russian)

94. Pasricha S.R., et al. Effect of daily iron supplementation on health in children aged 4-23 months: a systematic review and metaanalysis of randomised controlled trials. Lancet Glob. Health. 2013; 1 (2): e77-86.

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)