The process of haematopoiesis begins as early as 3 rd week of gestation in the yolk sac. The objective of this review is to discuss the physiology, the causes, clinical presentation and approach to the newborn anemia. Usually the diagnosis will be straight forward if approached in a systematic manner. The causes of anemia in newborns can be prenatal, natal or postnatal. It is the combination of developmentally regulated physiologic processes (anemia of prematurity ) along with concomitant pathologic and iatrogenic processes that contribute to the progressive anemia experienced by virtually all preterm infants. Secondly, as a group, preterm infants are particularly prone to developing electrolyte and acid-base imbalance, and infective illnesses, the diagnosis and management of which requires frequent laboratory assessment, resulting in significant phlebotomy loss. Firstly, the severity of the developmental postnatal decrease in Hb is most pronounced in the least mature infants, placing them at higher risk of developing clinically significant anemia. Preterm infants are especially vulnerable to these processes for two reasons. The ultimate severity and rapidity with which this anemia develops are determined by a combination of multiple physiologic and non-physiologic processes. Immediately following birth, all infants universally experience a decrease in hemoglobin (Hb) that results in varying degrees of anemia. Anemia in the new born is the commonest hematological problem.
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