The association of severe anemia, red blood cell transfusion and necrotizing enterocolitis in neonates

• Published in: PloS one Vol. 16; no. 7; p. e0254810
• Main Authors: Song, Juan, Dong, Huimin, Xu, Falin, Wang, Yong, Li, Wendong, Jue, Zhenzhen, Wei, Lele, Yue, Yuyang, Zhu, Changlian
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 20.07.2021; Public Library of Science (PLoS)
• Subjects: Abdomen; Anemia; Antibiotics; Biology and Life Sciences; Birth weight; birth-weight infants; Blood; Blood transfusion; Brain research; care; Complications; Complications and side effects; Enterocolitis; Enterocolitis, Neonatal necrotizing; Enterocolitis, Pseudomembranous; Erythrocytes; Gastrointestinal diseases; Gestational age; Health aspects; Health risks; Hemoglobin; Hospitals; Infants; Infants (Newborn); Laboratories; Low birth weight; Medicin och hälsovetenskap; Medicine and Health Sciences; Mortality; Necrosis; Necrotizing enterocolitis; Neonates; Neurosciences; Neurovetenskaper; Newborn babies; Normal distribution; Pediatrics; People and Places; Premature babies; Premature birth; premature-infants; Respiratory distress syndrome; Risk; Risk factors; Science & Technology - Other Topics; Sepsis; Thrombocytopenia; Transfusion; Traumatic brain injury; Weight; Sweden; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0254810

Background The relationship between severe anemia, red blood cell transfusion and Neonatal necrotizing enterocolitis (NEC) remains controversial. The purpose of this study was to determine the association of severe anemia and RBC transfusion with NEC in neonates. Methods The clinical characteristics of NEC were observed in 467 infants with different birth weights from January 2012 to July 2020. A 1:1 ratio case-control study was performed in very low birth weight (VLBW) infants. Severe anemia, RBC transfusion, and confounding factors, including maternal and perinatal complications, feeding, and antibiotics administration were collected in both groups. Univariate and multivariate analyses were used to investigate effects on the risk of NEC. Results The day of NEC onset and mortality were inversely associated with birth weight. In VLBW infants, adjusting for other factors, severe anemia within 72 h [OR = 2.404, P = 0.016], RBC transfusion within 24 h [OR = 4.905, P = 0.016], within 48 h [OR = 5.587, P = 0.008], and within 72 h [OR = 2.858, P = 0.011] increased the risk of NEC. Conclusion Both severe anemia and RBC transfusion appears to increase the risk of NEC in VLBW infants. The early prevention and treatment of anemia, strict evaluation of the indications for transfusion and enhanced monitoring after transfusion is encouraged in the NICU.