Anemia is the most common hematological disorder in the neonate. During the first weeks of life, all infants experience a decline in blood hematocrit values.
The main cause of anemia is a rapid fall in erythropoietin production after birth due to increased oxygen saturation. This process is called physiologic anemia of the newborn.
Anemia of prematurity is related to a combination of factors including increased iatrogenic losses from blood sampling, shorter red blood cells life span due to fetal hemoglobin, and rapid growth. Blood transfusion remains still the gold standard in the treatment of anemia of prematurity.
Between 60 to 100% of preterm infants (80% of VLBW and 95% of ELBW infants) are transfused before three weeks of age. The need of late transfusions decreases with the use of recombinant human erythropoietin.
Despite an extensive number of studies, there is currently no clear consensus regarding erythropoietin benefit in the treatment of anemia of prematurity.