Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Sep-Dec;2(3-4):99-106.
doi: 10.1016/j.ijpam.2015.10.001. Epub 2015 Nov 24.

Prevention of the anaemia of prematurity

Serdar Alan  1 , Saadet Arsan  2
Affiliations
Review

Prevention of the anaemia of prematurity

Serdar Alan et al. Int J Pediatr Adolesc Med. 2015 Sep-Dec.

Abstract

Despite recent advances in neonatal and perinatal medicine, extremely low birth weight infants (ELBW) are at high risk of developing anaemia of prematurity (AOP) requiring packed red blood cell (RBC) transfusions. The benefit of transfusing allogenic RBCs for AOP is a controversial issue, except for disturbances in tissue oxygenation. Although the role of erythropoietin (EPO) in the pathophysiology of AOP is well known, neither early nor late recombinant human EPO therapy alters the number or volume of RBC transfusions. It is also known that one-half of the feto-placental blood volume remains outside the newborn infant's circulation at 30 weeks of gestation if the umbilical cord is clamped immediately. Delayed cord clamping (DCC) and umbilical cord milking (UCM) are the main methods for enhancing placental transfusion. The basic principle of these approaches depends on providing high haemoglobin (Hb) levels to premature infants in the delivery room. The enhancement of placental transfusion clearly results in higher Hb levels at birth, reducing the need for RBC transfusions as well as creating a better haemodynamic status during the initial hours of life. To date, enhancement of placental transfusion in the delivery room by either DCC or UCM seems to be the best preventive measure for AOP. Yet, studies on the associated neurodevelopmental outcomes are insufficient to reach a conclusion. This review summarizes the pathophysiology, treatment and preventative strategies of anaemia of prematurity in light of the current literature.

Keywords: Anaemia of prematurity; Delayed cord clamping; Placental transfusion; Umbilical cord milking.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Therapeutic and preventive strategies for anaemia of prematurity.
See this image and copyright information in PMC

References

    1. Carroll P.D. Umbilical cord blood-an untapped resource: strategies to decrease early red blood cell transfusions and improve neonatal outcomes. Clin Perinatol. 2015;42(3):541–556. - PubMed
    1. Juul S. Erythropoietin in anemia of prematurity. J Matern Fetal Neonatal Med. 2012;25(5):80–84. - PubMed
    1. Bell E.F., Strauss R.G., Widness J.A., Mahoney L.T., Mock D.M., Seward V.J. Randomized trial of liberal versus restrictive guidelines for red blood cell transfusion in preterm infants. Pediatrics. 2005;115:1685–1691. - PMC - PubMed
    1. Kirpalani H., Whyte R.K., Andersen C., Asztalos E.V., Heddle N., Blajchman M.A. The Premature Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants. J Pediatr. 2006;149:301–307. - PubMed
    1. Martin J.A., Hamilton B.E., Sutton P.D., Ventura S.J., Mathews T.J., Osterman M.J. Births: final data for 2008 National Vital Statistics Reports. Centers Dis Control Prev. 2009;57:7. - PubMed