Anemia of prematurity: how low is too low?

Cibulskis, Catherine C.; Maheshwari, Akhil; Rao, Rakesh; Mathur, Amit M.

doi:10.1038/s41372-021-00992-0

Cited by 25 publications

(23 citation statements)

References 118 publications

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“…Our observation adds to prior evidence of association from smaller studies. 31,32 Severe anemia (i.e. hemoglobin < 8) has been postulated as one of the first events in a cascading series of bowel-hypoxia-ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…hemoglobin < 8) has been postulated as one of the first events in a cascading series of bowel-hypoxia-ischemia. 32 Our findings suggest that the hemoglobin level in either mothers or neonates may also be associated with the development of NEC, as lower hemoglobin levels in mothers shortly after conception (mean maternal hemoglobin after conception was 13.1 g/dL for newborns who did not develop NEC and 12.0 g/dL for those who later develop NEC, p=0.02) and at delivery (mean of 11.4 and 10.9 g/dL for those without and with NEC, p<0.001) were correlated with neonates who later developed NEC. Additionally, neonatal hemoglobin level at birth, along with greater variance in the hemoglobin levels over the first two months of life was also associated with development of NEC ( Figure 5E ).…”

Section: Discussionmentioning

confidence: 99%

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AI-Driven Longitudinal Characterization of Neonatal Health and Morbidity

Francesco

Reiss

Roger

et al. 2022

Preprint

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While prematurity is the single largest cause of death in children under 5 years of age, the current definition of prematurity, based on gestational age, lacks the precision needed for guiding care decisions. Here we propose a longitudinal risk assessment for adverse neonatal outcomes in newborns based on a multi-task deep learning model that uses electronic health records (EHRs) to predict a wide range of outcomes over a period starting shortly after the time of conception and ending months after birth. By linking the EHRs of the Lucile Packard Children’s Hospital and the Stanford Healthcare Adult Hospital, we developed a cohort of 22,104 mother-newborn dyads delivered between 2014 and 2018. This enabled a unique linkage between long-term maternal information and newborn outcomes. Maternal and newborn EHRs were extracted and used to train a multi-input multi-task deep learning model, featuring a long short-term memory neural network, to predict 24 different neonatal outcomes. An additional set of 10,250 mother-newborn dyads delivered at the same Stanford Hospitals from 2019 to September 2020 was used to independently validate the model, followed by a separate analysis of 12,256 mothers-newborn dyads at the University of California, San Francisco. Moreover, comprehensive association analysis identified multiple known and new associations between various maternal and neonatal features and specific neonatal outcomes. To date, this is the largest study utilizing linked EHRs from mother-newborn dyads and would serve as an important resource for the investigation and prediction of neonatal outcomes. An interactive website is available for independent investigators to leverage this unique dataset: https://maternal-child-health-associations.shinyapps.io/shiny_app/.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

AI-Driven Longitudinal Characterization of Neonatal Health and Morbidity

Francesco

Reiss

Roger

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…Higher haemoglobin levels in preterm infants are associated with increased blood iron storage [ 35 ], improved neural development [ 36 ], and lower rates of intraventricular haemorrhage [ 37 ]. Conversely, anaemia in preterm infants is associated with slower weight gain, poor oral intake, higher risk of cardiovascular events, and exacerbation of apnoeic episodes [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Haemoglobin Levels in Early Life among Infants with and without Retinopathy of Prematurity

Pheng

Lim

Tai

et al. 2021

IJERPH

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Retinopathy of prematurity (ROP) is a proliferative retinal vascular disorder attributed to an ischaemic stimulus in preterm infants. Haemoglobin, the main component for oxygen transportation, may be implicated in ROP development. This retrospective study compared the mean weekly haemoglobin levels between infants with and without ROP over the first six weeks of life. Premature infants of less than 32 weeks gestational age and less than 1.5 kg birth weight were grouped into age and birth weight-matched ROP cases and controls. Weekly mean haemoglobin levels were documented. An independent t-test was used to analyze the difference in mean haemoglobin levels between infants with ROP and infants without ROP. Adjustment for confounders was performed using one-way analysis of covariance. There was a statistically significant difference in adjusted mean haemoglobin levels between the ROP and non-ROP group during the first week of life (p = 0.038). No significant intergroup differences were observed at the other weeks. Haemoglobin monitoring during the first week of postnatal life may be useful to guide ROP screening in premature infants.

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“…Yaklaşık %50 olan fetal Hb oksijen konsantrasyonu doğumdan hemen sonra dakikalar içinde %95 ve üstüne çıkar [8]. İntrauterin dönemde yüksek olan EPO doğum sonrası intrauterin döneme göre doku oksijen konsantrasyonunun yüksekliği sebebiyle hızla azalır.…”

Section: Etiyopatogenezunclassified

“…Ayrıca bu bebeklerde kan kaybına neden olabilecek başka nedenler ve EPO üretiminin baskılanması gibi nedenler daha ciddi ve erken dönemde anemi gelişmesine sebep olur [1]. Prematüre bebeklerde hipoksiye EPO cevabı (EPO klerensinin yüksek olması, hızlı dağılımı ve hızlı eliminasyonu nedeniyle) term bebeklere kıyasla daha yetersizdir [1,8]. Şekil 1, Şekil 2'de doğumda gestasyonel haftaya göre referans Hb ve Htc değerleri, Şekil 3-6'da ise 29-42. gebelik haftaları arasında doğan bebeklerin postnatal ilk 28 gündeki Hb ve Htc referans değerleri gösterilmiştir [9].…”

Section: Etiyopatogenezunclassified

Prematürede anemi ve transfüzyon politikaları

ÖZDEMİR¹

2021

Pamukkale Medical Journal

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Yenidoğan döneminde anemi, fizyolojik olabildiği gibi prenatal, perinatal ve postnatal pek çok neden sonucu gelişebilmekte, ancak özellikle aşırı prematüre bebeklerde en önemli anemi nedenlerinden birisini iyatrojenik kan kayıpları oluşturmaktadır. Anemi saptanan bir yenidoğanda eritrosit transfüzyon kararı doku oksijenizasyonunu optimize edecek kan hemoglobin veya hematokrit düzeylerinin devamlılığının sağlanması amacıyla verilmektedir. Bunun için ise pratikte bebeğin kan hemoglobin ve/veya hematokrit düzeyi ve klinik durumu önem kazanmaktadır. Eritrosit transfüzyonunun pek çok potansiyel kompliksayonu da düşünüldüğünde prematüre bebeklere eritrosit transfüzyonu kararı verilirken kar-zarar oranı gözetilerek, güncel uygulamalar ışığında klinik bulguları eşliğinde bireyselleştirilmiş transfüzyon kararı verilmesi uygun gözükmektedir, ancak asıl amaç prematüre bebeklerde anemi gelişiminin önlenmesi olmalıdır.Bu derlemede prematüre anemisi, tanısı, transfüzyon tedavisi, komplikasyon ve korunma stratejileri son güncel uygulamalar ışığında verilmeye çalışılmıştır.

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Anemia of prematurity: how low is too low?

Cited by 25 publications

References 118 publications

AI-Driven Longitudinal Characterization of Neonatal Health and Morbidity

AI-Driven Longitudinal Characterization of Neonatal Health and Morbidity

Haemoglobin Levels in Early Life among Infants with and without Retinopathy of Prematurity

Prematürede anemi ve transfüzyon politikaları

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