Red blood cell transfusion, feeding and necrotizing enterocolitis in preterm infants

M. El-Dib, Sherry Kalla, E. Lee, A. N. Massaro, H. Aly

Research output: Contribution to journalArticle

Abstract

Objective: Preliminary studies suggested an association between red blood cell (RBC) transfusion and necrotizing enterocolitis (NEC) in premature neonates. An advantageous effect of withholding feeds during transfusion has never been studied. We aimed, first, to determine whether preterm infants who developed NEC were more likely to be transfused in the 48 to 72 h before the diagnosis of NEC; second, to test if a strict policy of withholding feeds during transfusion would decrease the incidence of transfusion-associated NEC. Study Design: The study was conducted in two phases. Phase 1: a retrospective case-control study of premature low-birth weight (<32 weeks and <2500 g) infants who developed NEC over a 6-year period. Phase 2: a comparison study of the incidence of NEC during the 18-months preceding, and the 18 months following the change of practice to withholding feeds during RBC transfusion. Result: In the case-control study (25 infants with NEC and 25 controls), more infants in the NEC group received transfusions in the 48 and 72 h preceding diagnosis (56 vs 20% within 48 h, P = 0.019; and 64 vs 24% within 72 h, P = 0.01). The total number of transfusions and age of RBCs were not different between the two groups. Implementing the policy of withholding feeds during transfusion was associated with a decrease in the incidence of NEC from 5.3 to 1.3% (P = 0.047). Conclusion: Infants who developed NEC frequently received RBC transfusions in the 48 and 72 h preceding presentation of NEC. A strict policy of withholding feeds during transfusion may have a protective effect from NEC.

Original languageEnglish (US)
Pages (from-to)183-187
Number of pages5
JournalJournal of Perinatology
Volume31
Issue number3
DOIs
StatePublished - Mar 2011
Externally publishedYes

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Erythrocyte Transfusion
Necrotizing Enterocolitis
Premature Infants
Case-Control Studies
Incidence
Premature Birth
Low Birth Weight Infant
Cohort Studies

Keywords

  • NEC
  • prematurity
  • red blood cells

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Red blood cell transfusion, feeding and necrotizing enterocolitis in preterm infants. / El-Dib, M.; Kalla, Sherry; Lee, E.; Massaro, A. N.; Aly, H.

In: Journal of Perinatology, Vol. 31, No. 3, 03.2011, p. 183-187.

Research output: Contribution to journalArticle

El-Dib, M. ; Kalla, Sherry ; Lee, E. ; Massaro, A. N. ; Aly, H. / Red blood cell transfusion, feeding and necrotizing enterocolitis in preterm infants. In: Journal of Perinatology. 2011 ; Vol. 31, No. 3. pp. 183-187.
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