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 journalArticlepeer-review

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)
Pages (from-to)972-978.e3
JournalJournal of Pediatrics
Volume157
Issue number6
DOIs
StatePublished - Dec 2010
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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