What are the diagnostic criteria for anemia in newborns?

The physical health of a newborn is what the family is most concerned about. If there is a problem with the newborn's body, the parents will definitely be very worried. Therefore, we recommend that parents and friends learn more about how to care for newborns. Once the newborn's body shows abnormalities, parents should help the newborn to deal with it in time. Below we will introduce to you the diagnostic criteria for neonatal anemia.

Neonatal examination

Anemia in newborns can be caused by blood loss, hemolysis, and low red blood cell (RBC) production. Blood loss can occur before birth (fetoplacental, fetofetal, and fetomaternal transfusions), during birth (umbilical cord rupture, placenta previa), and after birth (intracranial hemorrhage, visceral rupture). The most common cause of hemolysis is incompatibility of maternal and fetal blood types. It can also be caused by maternal autoimmune diseases, drugs, intrauterine infection, and neonatal RBC membrane or enzyme defects. Low RBC production is extremely rare in the neonatal period.

Clinical manifestations of anemia

Acute anemia is usually caused by blood loss and is often accompanied by pallor, shortness of breath, increased heart rate, and hypotension. The hematocrit (HCT) may be normal initially but may fall within 6 hours due to hemodilution. Chronic anemia may cause pallor, but there are no clinical symptoms of distress due to compensation. The liver and spleen may be enlarged, and some children may develop congestive heart failure.

Laboratory tests

(1) Immediately find the cause of anemia: ① Check the placenta; ② Observe the RBC morphology and reticulum RBC count on a blood smear; ③ Direct Coombs test; ④ Calculate the fetal RBC to maternal RBC ratio on a maternal blood smear (acid elution method) to exclude fetal-maternal transfusion.

(2) Other optional tests: ① Specific IgM antibody test (rubella, CMV, toxoplasmosis, parvovirus B19); ② hemostasis and coagulation test; ③ RBC enzyme test and Hb electrophoresis; ④ imaging examination to find the site of bleeding.

Physiological anemia of premature infants

The umbilical cord blood Hb level of premature infants at birth is similar to that of full-term infants, but physiological anemia occurs early (4 to 6 weeks) and is severe (Hb 70 to 100 g/L). The younger the gestational age, the more severe the anemia and the longer it lasts. This is primarily due to low erythropoietin (EPO) levels in premature infants, but is also related to the short lifespan of RBCs and the frequent diagnostic blood draws required in premature infants.

In the above article, we introduced one of the things that parents are most concerned about, that is, the physical health of newborns. We recommend that parents learn some methods of caring for newborns. The above article gives us a detailed introduction to the diagnostic criteria for neonatal anemia.