FEATURES OF ANEMIA IN PREMATURE CHILDREN IN THE NEONATAL PERIOD

The aim of the research. To study the severity of anemia of prematurity, laboratory parameters of peripheral blood analysis (MCV, MCH, MCHС), the level of iron in blood serum, ferritin in premature infants of different gestational periods. To assess the effectiveness of conservative therapy and the need for substitution transfusions depending on the term of prematurity.

Materials and methods. 82 medical histories of preterm infants of different gestational periods were retrospectively analyzed. Of these, 12 children were extremely premature, 36 children were very premature, 27 were moderately premature, and 7 were late premature.

Results. In extremely premature (EN) infants, anemia developed in 100%, severe and moderate form - in 16.7%, mild in 66.6%, in very premature infants (OH) anemia was diagnosed in 94.6%, of which severe form in 5.6%, moderate – 22%, light – 67%. In groups of children over 32 weeks of gestation, severe forms were not identified. In infants with EN, the iron level at 2 weeks Me 10.6 μmol / l [8.8; 12.1], which is significantly lower than in the comparison groups: with a gestational age of 29-32 weeks - 15.95 μmol / l [12.3; 18.9], (p = 0.007), 32-34 weeks of prematurity - 21.6 μmol / L [15.8; 20.5] (p = 0.0002), in late prematurity - 21, 3 μmol / L [16.2; 23.8]. Serum ferritin in the EN group is 58.4 μg / L [52.8; 71.7], statistically significantly lower than the level in children with OH, its level is 165.5 μg / L [77.3; 195], the difference is p = 0.03. Indicators of the total iron-binding capacity of serum, MCV, MCH did not reflect the etiology of anemia, MCHC is reduced in all groups of premature babies. With oral subsidization of 3-valent iron in therapeutic doses, a significant increase in the level of iron in blood serum was determined in the EN group before treatment 10.65 μmol / L [8.2; 12.1] after 2 weeks 21.95 [17.8; 23,9] p = 0.011. In infants of the comparison groups, no significant increase in serum iron levels was obtained.

Conclusion. Severe and moderate degrees of early anemia of preterm infants are diagnosed in groups of extremely and very preterm infants. A significant deficiency of serum iron was found in extremely premature infants at the age of 2 weeks of life. MCHC less than 33.1% registered in all groups of premature babies, is a marker of early anemia of premature babies. Iron supplementation in a therapeutic dose is required for children with EN; if enteral forms are impossible, it is advisable to prescribe parenteral forms of the drug.

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