Etiological profile, clinical course immediate outcome and short term follow-up of anemia in newborn

Abstract

Background and objectives: Neonatal anemia is one of the most common hematological problems encountered in NICU. We designed a study to determine the etiological profile, clinical course, immediate outcome and short term follow up of anemia in new born. Methods: 62 neonates admitted in NICU with hemoglobin < 14 gm % or who develop anemia during stay in NICU in one year period were included in our study. The association of anemia with various variables and the immediate outcome was studied. The clinical course of the anemic neonates was observed and followed up over a period of 6 months. The outcome was assessed. Data were analysed using statistical software SPSS 14.0. Results: The prevalence of anemia was 10.76% in our NICU. The most common etiologic association with anemia was septicemia (53%). Other common etiologies were iatrogenic blood loss (20%), Rh incompatibility (8%), ABO incompatibility (8%), VKDB (6.4%). Common symptoms and signs are poor feeding (32.2%), jaundice (24.1%), hurried breathing (22.5%), lethargy (17.7%), pallor (30.6%), tachypnea (24.1%) and increased oxygen requirement (20.9%). 37% of anemic neonates needed blood transfusion. Mortality was higher in preterm babies. Overall immediate outcome was satisfactory in 59.7%. Hemoglobin reached nadir of 9.7gm% at 3 months of age. Overall neurodevelopmental outcome was good in 42.3% of cases. Interpretation and conclusion: Neonatal anemia is a common neonatal hematological problem. Preterm babies underwent significantly large amount of iatrogenic blood loss (p<0.05). Blood transfusion significantly reduced heart rate, respiratory rate, increased SPO2. There was no significant difference between immediate outcome between preterm and term anemic neonates. Maternal anemia was significantly associated with lower hemoglobin levels at 6 months of age. Babies born via cesarean section had significantly lower levels of hemoglobin at 6 months. There was no association between birth weight, gestational age and hemoglobin level at admission. Tight nuchal cord was not associated with significantly lower level of hemoglobin. Delayed cord clamping did not show significantly increased levels of hemoglobin.