Lessons from the anemia of prematurity.

In our view, three main lessons stem from consideration of the refractory early anemia of prematurity (REAP). These are: (1) Hemoglobin concentration is not enough to describe the anemia. (2) The REAP may be clinically very severe but is often easily missed. It interacts with and worsens other causes of anemia in preterm infants, such as blood losses. Its pathogenesis is multifactorial, but it is generally interrelated with short gestation and its other complications. (3) Prevention, prophylaxis, and if necessary, adequate management are very important.