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, 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
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.
Conflict of interest statement
Conflicts of interest: The authors have no relevant conflicts to disclose.
Copyright © 2010 Mosby, Inc. All rights reserved.
Source: PubMed