Anemia

Anemia is defined as a decrease in the amount of hemoglobin or the number of red blood cells (red blood cells). Occasionally, hemoglobin and red blood cells may decrease.

Causes

• Physiological anemia of the newborn: it is a normal situation for all newborns. In term neonates (born with more than 37 weeks of gestation) it occurs between the 6th and 12th week of life; in premature infants, between the 4th and 8th week. This anemia is a normal adaptation of the newborn and does not require treatment. In a few weeks, the hemoglobin and red blood cells return to normal.

It is mainly due to two factors:

• Hemolysis of red blood cells during the first weeks of life (red blood cells have a shorter life than those of the adult).
• Life inside the womb is poor in oxygen; this is a stimulus for the production of red blood cells. At birth, the atmosphere in which we live is rich in oxygen and this reduces the stimulus to produce red blood cells.
• Pathological anemia of the newborn: it is anemia caused by a disease or disorder of the newborn:
• Loss of blood:
• Hemorrhages during childbirth: placenta previa, placental abruption, vasa previa, umbilical cord rupture
• Occult blood loss: fetomaternal, fetoplacental, or twin-to-twin transfusion. In these cases, the baby's blood is transferred to another (mother, brother or placenta), so that the fetus remains anemic.
• Hemorrhage in the neonatal period: intracranial hemorrhage, massive cephalohematoma, ruptured liver or spleen, intestinal bleeding
• Hemolysis: caused by conditions or diseases that destroy red blood cells:
• blood group incompatibilities: AB0, Rh (see section)
• Autoimmune diseases of the mother.
• Hereditary diseases of the red blood cells: spherocytosis, glucose-6-phostate-dehydrogenase deficiency or thalassemia
• Infections
• Vitamin E deficiency
• Decrease in the production of red blood cells:
• Infections
• Leukemia
• Drug side effects

Symptoms

Symptoms depend on how quickly the drop in hemoglobin or red blood cells occurs. In cases of acute anemia (such as hemorrhages), where the drop is very abrupt, the symptoms are very florid: paleness, high heart rate, low blood pressure, shortness of breath and shock.

When anemia occurs slowly, the body can compensate for the losses and the symptoms appear more covertly: decreased appetite and weight gain, heart murmur, enlargement of the liver and spleen, heart failure, edema, sickness general and irritability.

Treatment

In physiological anemias, no type of treatment is necessary because they do not cause any problems for the baby and they resolve on their own.

Whenever a newborn is diagnosed with anemia, the cause must be found.

The treatment of anemia in newborns consists of the replacement of blood through transfusions and specific treatment according to the cause that originates it.