Do Red Cell Transfusions Increase the Risk of Necrotizing Enterocolitis in Premature Infants?

Overview

Journal J Pediatr

Specialty Pediatrics

Date 2010 Jul 24

PMID 20650470

Citations 41

Authors

Cassandra D Josephson

Agnieszka Wesolowski

Gaobin Bao

Martha C Sola-Visner

Golde Dudell

Marta-Ines Castillejo

Beth H Shaz

Kirk A Easley

Christopher D Hillyer

Akhil Maheshwari

Affiliations

Soon will be listed here.

Abstract

Objective: To test the hypothesis that red blood cell (RBC) transfusions increase the risk of necrotizing enterocolitis (NEC) in premature infants, we investigated whether the risk of "transfusion-associated" NEC is higher in infants with lower hematocrits and advanced postnatal age.

Study Design: Retrospective comparison of NEC patients and control patients born at < 34 weeks gestation.

Results: The frequency of RBC transfusions was similar in NEC patients (47/93, 51%) and control patients (52/91, 58%). Late-onset NEC (> 4 weeks of age) was more frequently associated with a history of transfusion(s) than early-onset NEC (adjusted OR, 6.7; 95% CI, 1.5 to 31.2; P = .02). Compared with nontransfused patients, RBC-transfused patients were born at earlier gestational ages, had greater intensive care needs (including at the time of onset of NEC), and longer hospital stay. A history of RBC transfusions within 48-hours before NEC onset was noted in 38% of patients, most of whom were extremely low birth weight infants.

Conclusions: In most patients, RBC transfusions were temporally unrelated to NEC and may be merely a marker of overall severity of illness. However, the relationship between RBC transfusions and NEC requires further evaluation in extremely low birth weight infants using a prospective cohort design.

Citing Articles

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Stored RBC transfusions leads to the systemic inflammatory response syndrome in anemic murine neonates.

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A Detailed Protocol for the Induction of Anemia and RBC Transfusion-associated Necrotizing Enterocolitis in Neonatal Mice.

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Retrospective cohort study of neonatal blood transfusion in China.

Ma T, Sun Y, Wang Q, Liu F, Hua K, Wang L BMC Pediatr. 2023; 23(1):621.

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Basavarajegowda A, Plakkal N Asian J Transfus Sci. 2023; 17(1):97-102.

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