The prevalence, risk factors, and clinical characteristics of neonatal anemia, a common complication of hemolytic disease of the fetus and newborn (HDFN), will be analyzed in an upcoming study.
Neonatal anemia is one of the most frequent hematological conditions in neonatal intensive care units (NICUs), especially among preterm and very low birth-weight infants. It is defined as hemoglobin (Hb) or hematocrit (Hct) levels below the expected range for gestational and postnatal age, which can compromise oxygen delivery to tissues and affect long-term neurological development
According to WHO criteria, anemia is diagnosed when Hb levels fall below 13 g/dL in term newborns and below 12 g/dL in preterm infants during the first week of life. Anemia in newborns can have many causes including a decreased erythropoietin (a substance produced in the kidney that stimulates red blood cell (RBC) production), shortened RBC lifespan (as in HDFN), rapid growth with increased iron demand, and other causes like acute blood loss.
Approximately 80% of extremely preterm infants require at least one red blood cell transfusion during hospitalization. Recent reports in Egypt indicate that more than 60% of preterm infants admitted to tertiary-level NICUs develop anemia, with many needing multiple transfusions within the first month.
The prospective study aims to determine the prevalence, risk factors, and clinical outcomes of neonatal anemia in a tertiary care NICU. All live-born neonates admitted within the first 24 hours of life, both term and preterm, are eligible. Infants with major congenital malformations, chromosomal abnormalities, or prior transfusions can not participate. Data will be collected using probability sampling to ensure representation, and outcomes will be monitored over one year.
The primary findings will assess how often anemia develops among NICU admissions and which factors increase the risk. The authors will focus on maternal and perinatal influences, such as gestational age, delivery complications, and neonatal conditions, to identify preventable contributors.
The study will also evaluate transfusion requirements and short-term outcomes like length of stay, morbidity, and mortality, which carry implications for NICU resource use and prognosis.
Results are expected to clarify whether certain risk factors such as prematurity, low birth weight, or iatrogenic blood loss have stronger associations with anemia. This information could inform strategies to minimize transfusion needs, including restrictive sampling practices, optimized iron supplementation, and better monitoring of at-risk neonates.
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