Do red cell transfusions increase the risk of necrotizing enterocolitis in premature infants?

Cassandra D. Josephson, Agnieszka Wesolowski, Gaobin Bao, Martha C. Sola-Visner, Golde Dudell, Marta Inés Castillejo, Beth H. Shaz, Kirk A. Easley, Christopher D. Hillyer, Akhil Maheshwari

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume157
Issue number6
DOIs
StatePublished - Dec 1 2010
Externally publishedYes

Fingerprint

Necrotizing Enterocolitis
Premature Infants
Erythrocyte Transfusion
Extremely Low Birth Weight Infant
Critical Care
Hematocrit
Gestational Age
Length of Stay
Retrospective Studies
Erythrocytes

Keywords

  • Intraventricular hemorrhage
  • IVH
  • NEC
  • Necrotizing enterocolitis
  • Neonatal intensive care unit
  • NICU
  • Odds ratio
  • OR
  • Patent ductus arteriosus
  • PDA
  • RBC
  • Red blood cell
  • Very low birth weight
  • VLBW

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Do red cell transfusions increase the risk of necrotizing enterocolitis in premature infants? / Josephson, Cassandra D.; Wesolowski, Agnieszka; Bao, Gaobin; Sola-Visner, Martha C.; Dudell, Golde; Castillejo, Marta Inés; Shaz, Beth H.; Easley, Kirk A.; Hillyer, Christopher D.; Maheshwari, Akhil.

In: Journal of Pediatrics, Vol. 157, No. 6, 01.12.2010.

Research output: Contribution to journalArticle

Josephson, CD, Wesolowski, A, Bao, G, Sola-Visner, MC, Dudell, G, Castillejo, MI, Shaz, BH, Easley, KA, Hillyer, CD & Maheshwari, A 2010, 'Do red cell transfusions increase the risk of necrotizing enterocolitis in premature infants?', Journal of Pediatrics, vol. 157, no. 6. https://doi.org/10.1016/j.jpeds.2010.05.054
Josephson, Cassandra D. ; Wesolowski, Agnieszka ; Bao, Gaobin ; Sola-Visner, Martha C. ; Dudell, Golde ; Castillejo, Marta Inés ; Shaz, Beth H. ; Easley, Kirk A. ; Hillyer, Christopher D. ; Maheshwari, Akhil. / Do red cell transfusions increase the risk of necrotizing enterocolitis in premature infants?. In: Journal of Pediatrics. 2010 ; Vol. 157, No. 6.
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AU - Sola-Visner, Martha C.

AU - Dudell, Golde

AU - Castillejo, Marta Inés

AU - Shaz, Beth H.

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AU - Hillyer, Christopher D.

AU - Maheshwari, Akhil

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