What is the reason for low hemoglobin in premature infants

Low hemoglobin in premature infants may be caused by factors such as insufficient iron reserves, inadequate secretion of erythropoietin, inadequate nutrient intake, chronic disease effects, and iatrogenic blood loss. It can be improved through iron supplementation, blood transfusion treatment, nutritional support, primary disease treatment, and reducing blood collection frequency.

1. Insufficient iron reserve:

The liver iron reserve of premature infants is only one-third of that of full-term infants, and fetal iron accumulation mainly occurs in the later stages of pregnancy. Insufficient gestational age leads to an innate lack of iron reserves, and rapid growth and development after birth further exacerbates the iron demand gap. Clinical manifestations include pale skin and feeding difficulties, which can be diagnosed through serum ferritin testing. It is recommended to supplement iron supplements such as protein succinate iron oral solution under the guidance of a doctor, combined with vitamin C to promote absorption.

2. Insufficient secretion of erythropoietin:

Fetal erythropoietin is mainly produced by the liver and gradually converted to kidney secretion after birth. Premature infants have underdeveloped kidney function, with erythropoietin secretion levels only 50% -60% of full-term infants. This situation often occurs before 32 weeks of corrected gestational age, manifested as a decrease in reticulocyte count. Recombinant human erythropoietin injection can be used for treatment, while monitoring blood pressure and iron metabolism indicators.

3. Nutritional intake disorders:

Premature infants with uncoordinated sucking and swallowing functions often experience feeding difficulties, with iron levels in breast milk only ranging from 0.3-0.9mg/L. Extra intestinal nutrition support for more than 2 weeks may lead to copper deficiency and affect iron metabolism enzyme activity. Typical manifestations include slow weight gain, pale nail beds, and the need to supplement heme through fortified breast milk or premature infant formula. If necessary, enteral nutrition pump support should be given.

4. Chronic disease consumption:

Diseases such as neonatal respiratory distress syndrome and necrotizing enterocolitis can increase the body's oxygen consumption and accelerate the destruction of red blood cells. Inflammatory factors can also inhibit bone marrow hematopoietic function, which often results in hemoglobin levels below 70g/L and an increase in C-reactive protein. Active treatment of the primary disease is required, and severe anemia patients should receive 10-15 ml of concentrated red blood cells per kilogram of body weight.

5. Iatrogenic bleeding: