Summary:
The administration of blood and blood derivatives in fetal, neonatal and infant
life requires specific knowledge and selected blood products. The compatibility
tests should take into account the blood type and blood group antibodies of the
fetus or neonate and those of the mother. Factors such as, the transfer of
maternal antibodies to fetal circulation through the placenta, the small body
mass and blood volume of fetus, neonate and infant and the immature immune
system, predispose to the occurrence of adverse reactions. The most common
adverse reactions include transfusion transmitted infections, mainly
transfusion-transmitted cytomegalovirus, alloimmunization against antigens
present on the red and white blood cells and platelets,
transfusion-associated graft-versus-host disease (TA-GVHD), risk of volume
overload and metabolic disorders as hyperkalemia and hypothermia. In fetal and
neonatal life the main indications for transfusion are the correction of anemia
caused mainly by the hemolytic disease most commonly due to Rhesus D
incompatibility and correction of thrombocytopenia due to an incompatibility
between mother’s platelet antigen and her fetus or neonate. In addition,
premature infants are the most multitransfused group of hospitalized patients
due to a condition defined as anemia of prematurity. In infants,
hemoglobinopathies, hematologic malignancies, surgeries and coagulation
abnormalities are the most common indications for administration of blood
derivatives. The transfusion should be based on well defined indications, so
as not to expose fetuses, neonates and infants at risk.
Keywords:
Transfusion, Fetus, Neonate, Infant, Anemia
