Prevalence and Factors Associated in Development of Anaemia in the Longstay Preterm Infant at Knh Newborn Unit

Abstract

Background About 15% of low birth weight preterms have anaemia at 2 months of age with about 50% of blood transfusions to extreme low birth weight infants occurring within the first 2 weeks when the infants are most sick and blood testing most intense. Several practices such as iron and folate prophylaxis are in place, yet despite this, 55% of blood of transfusions in Kenyatta National Hospital occur in infants aged 2 months and below. Objectives This study intended to investigate the prevalence of anaemia in the long stay preterm infants in the KNH NBU and also look at some common factors contributing to the development of this anaemia. Methods A cross-sectional study of randomly sampled cohort of infants born before completing 37 weeks of gestation and had stayed more than 14 days in the new-born unit at Kenyatta National Hospital. Clinical details and biographies were collected by a predesigned questionnaire. Aseptic micro-sampling techniques were employed to collect blood in the infants who satisfied the inclusion criteria. The outcome measures studied were: a complete blood count, peripheral blood film and a reticulocyte count. Quantitative data analysis and computation was carried out by use of SPSS Version 20 software Results The study found that the prevalence of anemia in long-stay preterm infants was 40% with a majority (85.5%) bearing a normocytic normochromic morphology. Anaemic infants had an average haemoglobin of 8.45 g/dl compared to 13.09g/dl for the non-anaemic babies. All factors investigated were found to increase the odds of developing anaemia in this population. They included cord clamping, type of delivery, birth weight, circumstances of delivery, maternal Hb xiii levels, blood transfusion, maternal infections, phlebotomy draws, episodes of illnesses and pregnancy type. Conclusions and recommendations The burden of anaemia in long stay preterm infants is still great despite the measures put in place. Common factors such as low maternal haemoglobin and cord clamping less than 1 minute contributed to development of anaemia. As such, we recommend prompt treatment of maternal anaemia and advocate for the practice of delayed cord clamping as some of the measures to reduce development of anaemia.