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Severe Anemia at Birth-Incidence and Implications.
Bahr, Timothy M; Lawrence, Shelley M; Henry, Erick; Ohls, Robin K; Li, Shihao; Christensen, Robert D.
Afiliação
  • Bahr TM; Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT. Electronic address: tim.bahr@imail.org.
  • Lawrence SM; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT.
  • Henry E; Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT.
  • Ohls RK; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT.
  • Li S; Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT.
  • Christensen RD; Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT.
J Pediatr ; 248: 39-45.e2, 2022 09.
Article em En | MEDLINE | ID: mdl-35660494
OBJECTIVE: To identify neonates with severe anemia at birth, defined by a hemoglobin or hematocrit value within the first 6 hours after birth that plotted below the 1st percentile according to gestational age. For each patient, we retrospectively determined whether caregivers recognized the anemia within the first 24 hours after birth and the probable cause and outcome of anemia. STUDY DESIGN: This was a retrospective cohort analysis of Intermountain Healthcare population-based data from neonates born between January 2011 and December 2020 who had a hemoglobin or hematocrit value measured within the first 6 hours after birth below the 1st percentile lower reference interval (hematocrit ∼35% in near-term/term neonates). RESULT: Among 299 927 live births, we identified 344 neonates with severe anemia at birth. In 191 of these neonates (55.5%), the anemia was recognized by caregivers during the first 24 hours. Anemia was more likely to be recorded as a problem (85%) if the hemoglobin was ≥2 g/dL below the 1st percentile (P < .001). The lowest hemoglobin values occurred in those in whom hemorrhage was the probable cause (P < .013 vs hemolysis and P < .001 vs hypoproduction, mixed cause, or indeterminant.) Treatment was provided to 39.5%. A retrospective review suggested that mixed mechanisms, particularly hemorrhagic plus hemolytic, occurred more commonly than was recognized at the time of occurrence. CONCLUSIONS: Severe anemia at birth often went unrecognized on the first day of life. Algorithm-directed retrospective reviews commonly identified causes that were not listed in the medical record. We postulate that earlier recognition and more accurate diagnoses would be facilitated by an electronic medical record-associated hemoglobin/hematocrit gestational age nomogram.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Anemia Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Anemia Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos