Updates in Neonatal Anemia and Thrombocytopenia: Causes, Risk Factors, and Management

Maged Naser, Mohamed MN, Lamia H. Shehata

Abstract


There is no worldwide agreement with respect to red cell and platelets transfusion thresholds, bringing about generally changing practices.

 The distinguishing proof of appropriate biomarkers for red cell and platelets transfusion    may add to a more individualized and viable transfusion practice.

 Restrictive platelet transfusion might be desirable over liberal rules in preterm neonates with thrombocytopenia.

 Prevention of neonatal anemia can be partly prevented by delayed cord clamping and iatrogenic blood loss.


Keywords


Anemia, Thrombocytopenia, Erythrocytes, Platelets, Transfusion

Full Text:

PDF

References


-Keir AK, Yang J, Harrison A, et al. Temporal changes in blood product usage in preterm neonates born at less than 30 weeks gestation in Canada. Transfusion 2015; 55(6); 1340-6.

-Christensen RD, Henry E, Wiedmeier SE, et al.Thrombocytopenia among extremely low birth weight neonates: data from multihospital health care system. J Perinatal2006; 26(6):348-53.

-Roberts l, StanworhS, MurrayNA.Thrombocytopenia in the neonate. Blood Rev 2008; 22(4); 173-86.

-Staworth SJ, ClarkeP, WattsT, et al., Prospective, observational study of out-comes in neonates with severe thrombocytopenia. Pediatrics 2009; 124(5):e826-34.

-Widness JA. Pathophysiology of anemia during neonatal period, including anaemiaof prematurity.Neoreviews2008;9(11);e520.

-Wideness JA,Madan,Grindeanu LA, et al.,Reduction in red blood cell transfuionsamog preterm infants; results of randomized trials with an in-line as and chemistry monitor. Pediatrics 2005; 115 (5); 1299-306.

-Alverson DC. The physiologic impact of anemia in the neonate .ClinPerinatol 1995; 22(3):609-25.

-MurrayNA, HowarthLJ, McCloyMP, etal. Platelet transfusion in the management of severe thrombocytopenia in neonatalintensive care unit patients.TransfusMed2002;12(1):35-41.

- VonLindernJS, LoprioreE. Management and prevention of neonatal anemia; current evidence and guidelines . Expert Rev Haematol 2014; 7(2):195-202.

-Whyte R.Kirplani H. Low versus high hemoglobin concentration threshold for blood transfusion for preventing morbidity and mortality in very low birth weight infants. Cochrane Database SysRev2011 ;( 11): CD000512,

-Banerjee J, Aladangady N. Biomarkers to decide red blood cell transfusion in newborn, Transfusion 2014;54(10):2574-82.

-Baily SM, Hendrics –Munoz KD, Wells JT , et al. Packed red blood cells transfusion increases cerebral and splanchnic tissue oxygen saturation in anemic symptomatic preterm infants Am J Perinatal 2010;27(6):445-53.

-Seidel D,BlaserA,GabuerC,et al.Changes in regional tissue oxygenation saturation and desaturation after red blood cell transfusion in preterm infants .J Perinatal 2013;33(4):282-7.

-Takahashi D,MatsuiM,Shigematsu R, et al.Effect of transfusion on the venous blood acetate level in very low birth weight infants .PediatrINT2009;51(3):321-5.

-Van Hoften JC,VerhagenEA,Keating P,et al. Cerebral tissue oxygen saturation and extraction in preterm infants before and after blood transfusion. Arch Dis Child Fetal Neoborn Ed2010; 95(5):F352-8.

-Furgesson DA, Hebert P, Hogan DL, et al. Effect of fresh blood cell transfusions on clical outcome in premature, very low birth weight infants :The ARIPI randomized trial.JAMA2012;308(14):1443-51.

-Stains by D, jones H, Wells AW, et al. adverse outcomes of blood transfusion in children: UK reports to the serious hazards of transfusion scheme 1996-2005. Br J Haematol2008; 141(1):73-9.

-Baer VR, LambertDK, HenryE, etal.Among very low birth weight neonates is red blood cell transfusion an independent risk factor for subsequently developing a severe intra ventricular hemorrhage? Transfusion 2011; 51(6):1170-8.

-Mohamed A, Shahps, Transfusion associated necrotizing enterocolitis: a meta-analysis of observationaldata.Pediatrics2012; 129(3):529-40.

-Hesse L,EberlW,Sschlaud M, et al. Blood transfusion iron load and retinopathy of prematurity .Eur J Pediatr 1997;156(6):465-70.

-Hirano K,MorinoT,KimH,etal.Blood transfusion increasesradical promoting non-transferrin bound iron in preterm infants, Arch Dis Child Fetal Neoborn Ed2001;84(3):F188-93.

-Ohlsson A, AsherSM.Early erythropoiesis-stimulating agents in preterm or low birth weight infants. Cochrane Database Syst Rev2017 ;( 11):CD004863.

-Aher SM, OhlssonA.Late erythropoietin for preventing red cell transfusion in preterm and/or low birth weight infants. Cochrane Database SystRev2014 ;( 4):CD004868.

-Xu Xj, HuangHY, ChenHL.Erythropoietin and retinopathy of prematurity: a met-analysis.Eur J Pediatr2014, 173(10):1355-64.

-ChouHH, Chung My, ZhouXG, etal.Early erythropoietin administration does not increase the risk of retinopathy on preterm infants.PediatrNeonatalol2017; 58(1):48-56.

-Ohls RK,Kamath-RayneBD, Christensen RD,etal.Cognetive outcomes of preterm infants randomized to darbepoetin , erythropoietin, or placebo.Pediatrics2014;133(6):1`023-30.

-Zuppa AA, AlighieriG, Calabrese V, etal. Recombinant human erythropoietin in the prevention of late anemia in intrauterine transfused neonates with Rh-isoimmunization. J PediatrHematolOncol2010; 32(3):e95-101.

-Nicaise C,GireC,CashaP,etal.Erythropoietin as treatment for late hypo regenerative anemia in neonates with Rh hemolytic disease after in utero exchange transfusion.FetalDiagn Ther2002;17(1):22-4.

-Bateman ST, LacroixJ, BovenK, etal.Anaemia, blood loss, and blood transfusion in North American Children in the intensive care unit. Am J RespirCrit Care Med 2008; 178(1):26-33.

-Valantine SL, BatemanST.Identifying factors to minimize phlebotomy-induced blood loss in the pediatric intensive care unit. PediatrCrit Care Med2012; 13(1):22-7.

-Rosenbraugh MR, Widness JA, NalbantD, etal. A mathematical modeling approach to quantify the role of phlebotomy losses and need for transfusions in neonatal anemia. Transfusion2013; 53(6):1353-60.

-World Health Organization. WHO guidelines delayed umbilical cord clamping for improved maternal and infant health and nutrion outcomes .Geneva (Switzerland): World Heath Organization; 2014.

-Rabe H, Diaz-RosselloJL, etal. Effect of timing umbilical cord clamping and strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane DatabaseSysRev2012 ;( 8):CD003248.

-McDonald SJ,MiddletonP,DowswellT,etal.Effect of timing umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev 2013 ;( 7) CD004074.

- RanaN, KcA, MalqvistM, etal.Effect of delayed cord clamping of term babies on neurodevelopment at 12 months: a randomized controlled trial. Neonatology 2018; 115(1):36-42.

-Andersson Lindquist B, Lindegren M, et al.Effect of delayed cord clamping on neurodevelopment at 4 years of age: a randomized clinical trial. JAMA Pediatr 2015; 169(7):631-8.

-Mattia G,VulcanoF,MilazzoL,et al. Different ploidy levels of megakaryocytes generated from peripheral or cord blood CD341 cells are correlated with different levels of platelets release .Blood2002;99(3):888-97.

-Debili N, WendlingF, Katz A,etal.TheMpl-ligand or thrombopoietin or megakaryocyte growth and differatiative factor has both direct proliferative activities on human megakaryocyte progenitors.Blood1995;86(7):2516-25.

-Widmeier SE, Henry E, Sola-Visner MC, etal. Platelet reference ranges for neonates using data from over 47,000 patients in multihospital health care system. J Perinatol2009; 29(2):130-6.

-Bonifacio L, Petrov A, Nanjundaswamy S, etal. Thrombocytopenia related neonatal outcome in preterms. Indian J PEDIATR2007; 74(3):269-74.

-Von LindernJS, Van den BrueleT, LoprioreE, etal. Thrombocytopenia in neonates and the risk of intra ventricular hemorrhage: a retrospective cohort study .BMC Pediatr2011; 11:16.

-Fustolo-Gunnink SF, Huijssen-HuismanE J, van der Bom JG, etal. Temporary removal: are thrombocytopenia and platelet transfusion associated with major bleeding in preterm neonates? A Systematic review. Blood Rev2018.

-Sola-VisnerM, SaxonhouseMA, Brown RE. Neonatal thrombocytopenia: What we do and don’t know. Early Human Dev2008; 84(8):499-506.

-Andrew M, Vegh P, CacoC, etal. Randomized, controlled trial of platelet transfusions in thrombocytopenic premature infants. J Pediatr1993; 123(2):285-91.

-Cremer A, Stanworth SJ, WilloghbyK,etal,Randomized trial of platelet transfusion threshold in neonates.NEngl J Med2019;380(3);242-51.

-Cremer M, Paetzold J, SchemalishG ,etal.Immature platelet fraction as novel laboryparameter predicting the course of fraction as novel laboratory parameter predicting the course of neonatal thrombocytopenia.Br JHaematol2009;144(4):619-21.

-Baer VL, LambertDK, HenryE, etal.Do platelet transfusions in the NICU adversely affects survival? Analysis of 1600 thrombocytopenic neonates in multi-hospital health care system.J Perinatol2007; 27(12):790-6.

-Li J, Yang C, Xia Y, et al.Thrombocytopenia caused by the development of anti-bodies to thrombopoietin.Blood2001;98(12):3241-8.

-Sallmon H, GuttiRK, Ferrer-MarinF, and etal. Increasing platelets without transfusion: is it time to introduce novel thrombopoietic agents in neonatal care? JPerinatol2010; 30(12):765-9.

-New HV,Berryman J,Bolton-Maggs PH,et al, British Committee for Standards in Haematology.Guidlines on transfusion for Standards in Hematology .Guidelines on transfusion for fetuses, neonates and older children.Br J Haematol2016;175(5):784-828.

-Australian National Blood Authority. Patient blood management guidelines: module 6 neonatal and pediatrics. Available at:://https.blood.gov.au/pbm-module6. Accessed October23, 2018.

-Lau W.Chapter13: neonatal and pediatric transfusion.blood.ca/en/transfusion/clinical-guide/neonatal-and-pediatric-transfusion.

-Dutch Guidelines Quality Council, 3RD revision, 2018.

-Estcourt LJ, BirchallJ, AllardS, et al, Birith Committee for Standards in Haematology.Guidlines for the use of platelet transfusions.Br Haematol2017; 176(3)365-94.




DOI: http://dx.doi.org/10.52155/ijpsat.v23.1.2304

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 Maged Naser, Mohamed MN, Lamia H. Shehata

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.