Establishing the Cause of Anemia in a Premature Newborn Infant

The three major causes of anemia in neonates are blood loss, decreased red blood cell production, and increased degradation of erythrocytes. Establishing the cause of anemia in a neonate born prematurely can be challenging. Clinically, fetomaternal hemorrhage (FMH) can be difficult to diagnose-the c...

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Bibliographic Details
Published in:Laboratory medicine 2018-08, Vol.49 (3), p.e74-e77
Main Authors: den Besten, Gijs, van der Weide, Karen, Schuerman, Frank A B A, Michael Cotten, C, Rondeel, Jan M M
Format: Article
Language:English
Subjects:
Anemia
Blood
Erythrocytes
Newborn babies
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Summary:The three major causes of anemia in neonates are blood loss, decreased red blood cell production, and increased degradation of erythrocytes. Establishing the cause of anemia in a neonate born prematurely can be challenging. Clinically, fetomaternal hemorrhage (FMH) can be difficult to diagnose-the condition often presents only after the manifestation of severe fetal anemia. FMH can be confirmed by determining the fetal hemoglobin F fraction in the mother, which is traditionally performed using the Kleihauer-Betke test (KBT). Herein, we present a case study of a newborn baby boy of Dutch ethnicity with massive FMH and negative KBT result. The KBT result appeared to be false-negative due to AO antagonism. However, the results of an additional marker alpha-fetoprotein (AFP) test confirmed the diagnosis of massive FMH. Therefore, measuring AFP in maternal blood can be helpful in confirming FMH in unexplained anemia of the neonate.
ISSN:0007-5027
1943-7730
DOI:10.1093/labmed/lmy026