Associations between Red Blood Cell Transfusions and Necrotizing Enterocolitis in Very Low Birth Weight Infants: Ten-Year Data of a Tertiary Neonatal Unit

Background and Objective: Necrotizing enterocolitis (NEC) remains an important cause of mortality in preterm neonates. There are many risk factors for NEC; however, probably the most controversial one is red blood cell transfusions (RBCT). The data concerning the link between NEC and RBCT has been conflicting. Therefore, we aimed to analyze the association between NEC and RBCT in Neonatal Intensive Care Unit (NICU) at the Hospital of Lithuanian University of Health Sciences. Materials and Methods: We used the Very Low Birth Weight (VLBW) Infants database to match all infants with ≥2a Bell’s stage NEC admitted between 1 January 2005 and 31 December 2014 (n = 54) with a control group (n = 54) of similar gestational age and birth weight and without NEC. We analyzed the charts of these infants and performed statistical analysis on 20 clinical variables including RBCT. Results: The main clinical and demographic characteristics did not differ between the two groups. All variables associated with RBCT (receipt of any RBCT, the number of transfusions and the volume transfused in total) were significantly higher in the NEC group both before the onset of NEC and throughout the hospitalization. RBCT increased the odds of NEC even after adjustment for confounding factors. In addition, we found that congenital infection was more abundant in the NEC group and increased the odds of NEC 2.7 times (95% confidence interval CI (1.1, 6.3), p = 0.024). Conclusions: A higher number and the total volume of RBCT are associated with an increased risk of NEC in VLBW infants. The presence of congenital infection might identify the infants at risk.

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Undergoing Multiple Red Blood Cell Transfusions is Associated With Poorer Outcomes in Very Low Birth Weight Infants

10.21203/rs.3.rs-693141/v1 ◽

2021 ◽

Author(s):

Xiaohong Fang ◽

Dali Huang ◽

Huibin Zeng ◽

Liping Xu

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Blood Cell ◽

Red Blood Cell ◽

Very Low Birth Weight ◽

Pearson Correlation ◽

Vlbw Infants ◽

Increased Risk ◽

Composite Risk ◽

Rbc Transfusion

Abstract Objective This study was designed to assess red blood cell (RBC) transfusion frequency in very-low-birth-weight (VLBW)infants and to understand the relationships between the number of transfusions and the composite risk of bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and mortality. Method: VLBW infants admitted from May 2017 – July 2019 were retrospectively analyzed. Relationships between gestational age (GA), birth weight (BW), numbers of transfusions, and comorbidities were evaluated through Pearson correlation analyses. The relationship between factors of interest (Model 1: GA, BW, comorbidities; Model 2: number of transfusions) and composite risk was assessed via a logistic regression approach. Results Overall,408 VLBW infants were enrolled, of whom 74% underwent at least one RBC transfusion. Infants with a GA < 30 weeks, a BW < 1,250 g, and comorbidities were more likely to require RBC transfusion. Number of transfusions was related to the risk of analyzed composite outcomes, with risk correlating with undergoing > 3 transfusions (OR: 3.275, 95% CI: 1.707–6.275). Conclusion We found that undergoing > 3 RBC transfusions was related to an increased risk of BPD, ROP, or death in VLBW infants.

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Unique risks of red blood cell transfusions in very-low-birth-weight neonates: associations between early transfusion and intraventricular hemorrhage and between late transfusion and necrotizing enterocolitis

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.3109/14767058.2013.830495 ◽

2013 ◽

Vol 26 (sup2) ◽

pp. 60-63 ◽

Cited By ~ 13

Author(s):

Robert D. Christensen ◽

Vickie L. Baer ◽

Antonio Del Vecchio ◽

Erick Henry

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Blood Cell ◽

Necrotizing Enterocolitis ◽

Red Blood Cell ◽

Intraventricular Hemorrhage ◽

Very Low Birth Weight ◽

Red Blood Cell Transfusions

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Faculty Opinions recommendation of Effect of fresh red blood cell transfusions on clinical outcomes in premature, very low-birth-weight infants: the ARIPI randomized trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717962101.793465795 ◽

2012 ◽

Author(s):

Daniel Sloniewsky

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Blood Cell ◽

Randomized Trial ◽

Clinical Outcomes ◽

Red Blood Cell ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Red Blood Cell Transfusions

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Effect of red blood cell transfusion on short-term outcomes in very low birth weight infants

Clinical and Experimental Pediatrics ◽

10.3345/kjp.2019.00990 ◽

2020 ◽

Vol 63 (2) ◽

pp. 56-62

Author(s):

Eui Young Lee ◽

Sung Shin Kim ◽

Ga Young Park ◽

Sun Hyang Lee

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Blood Cell ◽

Red Blood Cell ◽

Very Low Birth Weight ◽

Short Term ◽

Vlbw Infants ◽

Early Onset Sepsis ◽

The Relationship ◽

Rbc Transfusion

Background: Red blood cell (RBC) transfusion improves cardiorespiratory status of preterm infants by increasing circulating hemoglobin, improving tissue oxygenation, and reducing cardiac output. However, RBC transfusion itself has also been suggested to negatively affect short-term outcomes such as intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) in premature infants.Purpose: This study aimed to analyze the relationship between RBC transfusion and short-term outcomes in very low birth weight (VLBW) infants (birth weight, <1,500 g).Methods: We retrospectively reviewed the medical records of VLBW infants admitted to the Soonchunhyang University Bucheon Hospital between October 2010 and December 2017. Infants who died during hospitalization were excluded. The infants were divided into 2 groups according to RBC transfusion status. We investigated the relationship between RBC transfusion and short-term outcomes including BPD, ROP, NEC, and IVH.Results: Of the 250 enrolled VLBW infants, 109 (43.6%) underwent transfusion. Univariate analysis revealed that all shortterm outcomes except early-onset sepsis and patent ductus arteriosus were associated with RBC transfusion. In multivariate analysis adjusted for gestational age, birth weight and Apgar score at 1 minute, RBC transfusion was significantly correlated with BPD (odds ratio [OR], 5.42; <i>P</i><0.001) and NEC (OR, 3.40; <i>P</i>= 0.009).Conclusion: RBC transfusion is significantly associated with adverse clinical outcomes such as NEC and BPD in VLBW infants. Careful consideration of the patient’s clinical condition and appropriate guidelines is required before administration of RBC transfusions.

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