Updates in Neonatal Hematology: Causes, Risk Factors, and Management of Anemia and Thrombocytopenia

Anemia and thrombocytopenia occur frequently in preterm neonates. Anemia can be physiologic, but is mostly caused by iatrogenic blood sampling. Thrombocytopenia may be present at birth due to intrauterine disorders, but is most commonly detected after birth following bacterial infection. There is no consensus regarding optimal hemoglobin and platelet thresholds for transfusion. An increasing number of studies suggest that restrictive transfusion guidelines may be preferable to liberal guidelines. Better markers to assess the need of transfusions are needed as well as the implementation of effective preventive measures, such as delayed cord clamping and minimization of iatrogenic blood loss.