TY - JOUR
T1 - Do red cell transfusions increase the risk of necrotizing enterocolitis in premature infants?
AU - Josephson, Cassandra D.
AU - Wesolowski, Agnieszka
AU - Bao, Gaobin
AU - Sola-Visner, Martha C.
AU - Dudell, Golde
AU - Castillejo, Marta Inés
AU - Shaz, Beth H.
AU - Easley, Kirk A.
AU - Hillyer, Christopher D.
AU - Maheshwari, Akhil
PY - 2010/12
Y1 - 2010/12
N2 - 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.
AB - 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.
KW - IVH
KW - Intraventricular hemorrhage
KW - NEC
KW - NICU
KW - Necrotizing enterocolitis
KW - Neonatal intensive care unit
KW - OR
KW - Odds ratio
KW - PDA
KW - Patent ductus arteriosus
KW - RBC
KW - Red blood cell
KW - VLBW
KW - Very low birth weight
UR - http://www.scopus.com/inward/record.url?scp=78449278152&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78449278152&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2010.05.054
DO - 10.1016/j.jpeds.2010.05.054
M3 - Article
C2 - 20650470
AN - SCOPUS:78449278152
VL - 157
SP - 972-978.e3
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
IS - 6
ER -