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 language | English (US) |
|---|---|
| Journal | Journal of Pediatrics |
| Volume | 157 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 1 2010 |
| Externally published | Yes |
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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 journal › Article
}
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 - 2010/12/1
Y1 - 2010/12/1
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 - Intraventricular hemorrhage
KW - IVH
KW - NEC
KW - Necrotizing enterocolitis
KW - Neonatal intensive care unit
KW - NICU
KW - Odds ratio
KW - OR
KW - Patent ductus arteriosus
KW - PDA
KW - RBC
KW - Red blood cell
KW - Very low birth weight
KW - VLBW
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
VL - 157
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
IS - 6
ER -