Anemia in the newborn
also see Normal values, CBC, Anemia, physiologic, Hemolytic disease of the newborn

Presentation: Pallor, CHF, shock

Etiologies (think placenta, cord...)

Newborn anemia-workup

Flow diagram

  1. If Hb low, start with retic count
  2. If retic count
    1. low: consider congenital hypoplastic anemia. End.
    2. normal or high: do Coombs' test.
  3. If Coombs' test
    1. positive: consider immune hemolytic anemia ( incompatible ABO, Rh, Minor blood group i.e. Kell). End.
    2. negative: do MCV.
  4. If MCV
    1. low: consider chronic intrauterine blood loss or alpha thalassemia syndromes. End.
    2. normal or high: do peripheral blood smear
  5. If smear
    1. abnormal: consider hereditary spherocytosis/elliptocytosis, pyruvate kinase deficiency, G6PD Deficiency, DIC
    2. normal, consider:
      1. blood loss: i.e. iatrogenic sampling, fetomaternal or fetoplacental, twin-twin, or internal hemorrhage
      2. infection: i.e. C. welchii
      3. rare misc: ie hexokinase deficiency