Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants
Red blood cell (RBC) transfusion is often considered a life-saving measure in critically ill neonates. The smallest and least mature infants tend to receive the largest amount of transfusions. RBC transfusion itself has also been suggested as an independent risk factor of poor clinical outcome in cr...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-06-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957216300791 |
| _version_ | 1826575037254074368 |
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| author | Yu-Cheng Wang Oi-Wa Chan Ming-Chou Chiang Peng-Hong Yang Shih-Ming Chu Jen-Fu Hsu Ren-Huei Fu Reyin Lien |
| author_facet | Yu-Cheng Wang Oi-Wa Chan Ming-Chou Chiang Peng-Hong Yang Shih-Ming Chu Jen-Fu Hsu Ren-Huei Fu Reyin Lien |
| author_sort | Yu-Cheng Wang |
| collection | DOAJ |
| description | Red blood cell (RBC) transfusion is often considered a life-saving measure in critically ill neonates. The smallest and least mature infants tend to receive the largest amount of transfusions. RBC transfusion itself has also been suggested as an independent risk factor of poor clinical outcome in critical patients. Our aim is to study if there are associations between RBC transfusion and in-hospital mortality, short-term morbidities, and late neurodevelopmental outcome in extremely low birth weight (ELBW) preterm infants.
Methods: A cohort of ELBW preterm infants admitted to our neonatal intensive care unit from January 2009 to December 2010 were recruited. The number of RBC transfusions within 7 days, 30 days, and 60 days of life were recorded. Clinical outcomes including in-hospital mortality, development of retinopathy of prematurity (ROP), necrotizing enterocolitis, chronic lung disease, and later neurodevelopmental outcome were assessed with follow-up of up to 2 years of age. Multivariable logistic regression was used to estimate the associations between RBC transfusion and clinical outcomes.
Results: A total of 98 ELBW preterm infants survived at the time of discharge. Of these survivors, the mean numbers of RBC transfusions were 2.5 ± 1.7, 7.4 ± 3.1, and 11.3 ± 4.5 times within 7 days, 30 days, and 60 days after birth, respectively. The number of transfusions within 7 days of life was correlated with risk of death before 1 month of age (odds ratio: 1.54, 95% confidence interval: 1.04–2.27, p = 0.03) and the number of transfusions within 30 days was correlated with risk of developing threshold ROP (odds ratio: 1.27, 95% confidence interval: 1.04–1.55, p = 0.02). The number of transfusions within 7 days of life was positively correlated with cognitive performance (Mental Developmental Index score) at 18–24 months of corrected age.
Conclusion: RBC transfusion has a negative impact on survival in ELBW infants. It increases the risk of developing ROP and affects late neurodevelopment. Decisions of blood transfusion in these very immature infants should be made cautiously taking these deleterious results into consideration. |
| first_indexed | 2024-12-23T23:14:21Z |
| format | Article |
| id | doaj.art-bacc874a991c4bca9496eecb955104cb |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2025-03-14T13:08:20Z |
| publishDate | 2017-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-bacc874a991c4bca9496eecb955104cb2025-03-02T00:37:13ZengElsevierPediatrics and Neonatology1875-95722017-06-0158321622210.1016/j.pedneo.2016.03.009Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm InfantsYu-Cheng Wang0Oi-Wa Chan1Ming-Chou Chiang2Peng-Hong Yang3Shih-Ming Chu4Jen-Fu Hsu5Ren-Huei Fu6Reyin Lien7Department of Pediatrics, Ton-Yen General Hospital, Hsinchu, TaiwanDivision of Neonatology, Department of Pediatrics, Chang-Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang-Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang-Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang-Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang-Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang-Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang-Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan, TaiwanRed blood cell (RBC) transfusion is often considered a life-saving measure in critically ill neonates. The smallest and least mature infants tend to receive the largest amount of transfusions. RBC transfusion itself has also been suggested as an independent risk factor of poor clinical outcome in critical patients. Our aim is to study if there are associations between RBC transfusion and in-hospital mortality, short-term morbidities, and late neurodevelopmental outcome in extremely low birth weight (ELBW) preterm infants. Methods: A cohort of ELBW preterm infants admitted to our neonatal intensive care unit from January 2009 to December 2010 were recruited. The number of RBC transfusions within 7 days, 30 days, and 60 days of life were recorded. Clinical outcomes including in-hospital mortality, development of retinopathy of prematurity (ROP), necrotizing enterocolitis, chronic lung disease, and later neurodevelopmental outcome were assessed with follow-up of up to 2 years of age. Multivariable logistic regression was used to estimate the associations between RBC transfusion and clinical outcomes. Results: A total of 98 ELBW preterm infants survived at the time of discharge. Of these survivors, the mean numbers of RBC transfusions were 2.5 ± 1.7, 7.4 ± 3.1, and 11.3 ± 4.5 times within 7 days, 30 days, and 60 days after birth, respectively. The number of transfusions within 7 days of life was correlated with risk of death before 1 month of age (odds ratio: 1.54, 95% confidence interval: 1.04–2.27, p = 0.03) and the number of transfusions within 30 days was correlated with risk of developing threshold ROP (odds ratio: 1.27, 95% confidence interval: 1.04–1.55, p = 0.02). The number of transfusions within 7 days of life was positively correlated with cognitive performance (Mental Developmental Index score) at 18–24 months of corrected age. Conclusion: RBC transfusion has a negative impact on survival in ELBW infants. It increases the risk of developing ROP and affects late neurodevelopment. Decisions of blood transfusion in these very immature infants should be made cautiously taking these deleterious results into consideration.http://www.sciencedirect.com/science/article/pii/S1875957216300791extremely low birth weightmortalityneurodevelopmental outcomepreterm infantsRBC transfusion |
| spellingShingle | Yu-Cheng Wang Oi-Wa Chan Ming-Chou Chiang Peng-Hong Yang Shih-Ming Chu Jen-Fu Hsu Ren-Huei Fu Reyin Lien Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants Pediatrics and Neonatology extremely low birth weight mortality neurodevelopmental outcome preterm infants RBC transfusion |
| title | Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants |
| title_full | Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants |
| title_fullStr | Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants |
| title_full_unstemmed | Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants |
| title_short | Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants |
| title_sort | red blood cell transfusion and clinical outcomes in extremely low birth weight preterm infants |
| topic | extremely low birth weight mortality neurodevelopmental outcome preterm infants RBC transfusion |
| url | http://www.sciencedirect.com/science/article/pii/S1875957216300791 |
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