Anemia of Prematurity in an ELBW Neonate of Jehovah's Witness Parents.

Anemia of prematurity is a physiologic and iatrogenic process defined by gestational age and involves a decrease in an infant's red blood cell mass by 2 SD Severity is often inversely proportional to gestational age and the presence of comorbid conditions that alter erythropoietin production, reduce red blood cell life span and iron stores, and necessitate frequent serum blood draws. Blood transfusion is a common treatment for severe anemia, and when nonemergent it requires informed consent from a parent or a court-appointed guardian. Jehovah's Witness (JW) community members typically do not accept blood products based on their beliefs. This situation presents a unique ethical and legal dilemma for healthcare providers when the neonate's family denies lifesaving treatment. We present a case study of a 24 weeks' gestation infant born to parents of JW beliefs, as well as a discussion of the pathophysiology and clinical manifestations of anemia.