Determinants of anemia in premature newborns and the immediate outcome at the Mother and Child Center of the Chantal BIYA Foundation, Cameroon

Abstract

Background: Anemia is a common and serious health problem, especially in premature infants. The objective of this study was to identify the determinants of anemia in premature infants and the factors influencing their hospital outcome. Methods: This was a retrospective study in the neonatal unit of the Mother Child Center of the Chantal Biya Foundation. Were included, all premature babies admitted between January 1, 2013 and December 31, 2017, who at least had a full blood count done. Data collected from medical records focused on maternal and neonatal characteristics, clinical and laboratory features, treatment received and hospital outcome. Results: Among the 425 premature babies included, 140 (32.9%) had anemia and 14 (10%) died. The risk factors for anemia in the premature infants were age at admission over 24 hours (p = 0.002) and gestational age less than 32 weeks (p <0.001). The factors associated with mortality were female sex (p = 0.030), birth weight <1500g (p = 0.029), gestational age <32 weeks (p = 0.024). The presence of respiratory distress (p = 0.009), thrombocytopenia (p = 0.011), the need for oxygen (p <0.001) and the need for blood transfusion (p = 0.004) were risk factors for death. However only bradycardia was an independent clinical feature associated with death (p = 0.037). Conclusion: Anemia is very common in premature babies, and remains a high risk factor for death. The clinical and laboratory monitoring of anemic premature babies must be rigorous especially in babies born very preterm and with very low birth weight.

Prevalence of anaemia and associated factors among preterm infants at six weeks chronological age at Muhimbili National Hospital, Dar es Salaam, Tanzania: a cross-sectional study

“…We also found higher proportion of anaemia among moderate preterm infants compared to late preterm infants. These findings were similarly reported by other studies done in Cameroon [ 7 ], China [ 16 ] and Wales [ 4 ]. This is probably a reflection of the fact that haemoglobin increases with advancing gestation age, thus babies who are born before the 3 rd trimester of gestation are deprived of most of the iron transported from the mother and a great deal of in utero foetal erythropoiesis.…”

“…A high burden of anaemia found in this study could be due to the physiological post-natal haemoglobin drop which occurs in new-borns during the first weeks of life and reaches nadir level at approximately 4-6 weeks in preterm infants. However, other studies in Brazil [ 2 ], India [ 14 ], South Africa [ 3 ], Cameroon [ 7 ] and Ethiopia [ 6 ] reported lower proportions. This disparity of proportions across studies may partly be explained by the differences in the age of the study participants.…”

“…The prevalence of anaemia varies among studies with a range from 6% to 70% depending on post-natal age [ 2 - 6 ]. In rural South Africa at Moroka Hospital, 9.2% of preterm babies had anaemia before discharge [ 3 ] while in Cameroon and Ethiopia the prevalence of anaemia were reported to be 32.9% and 23.2% respectively [ 7 , 8 ]. In Tanzania around 336,000 babies are born prematurely annually which translates to around 17% of all live births [ 7 ] and magnitude of anaemia is estimated to be 58% among children aged 6 to 59 months [ 8 ].…”