Korean J Pediatr.  2013 Mar;56(3):112-115. 10.3345/kjp.2013.56.3.112.

Analysis of the association between necrotizing enterocolitis and transfusion of red blood cell in very low birth weight preterm infants

• Bak SY
• Lee S
• Park JH
• Park KH
• Jeon JH

• KMID: 2284281
• DOI: http://doi.org/10.3345/kjp.2013.56.3.112

Abstract

PURPOSE
To investigate the association between necrotizing enterocolitis (NEC) and red blood cell transfusions in very low birth weight (VLBW) preterm infants.
METHODS
We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell's criteria) and a control group (less than stage II on the modified Bell's critieria). We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18) in the NEC group and the frequency of transfusion until 18 days after birth in the control group.
RESULTS
Of the 180 subjects, 18 (10%) belonged to the NEC group, and 14 (78%) of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received 3.1+/-2.9 transfusions, and the control group received 1.0+/-1.1 transfusions before the NEC diagnosis (P=0.005). In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P=0.007) with transfusion before the NEC diagnosis.
CONCLUSION
The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.

Keyword

Necrotizing enterocolitis; Very low birth weight infants; Red blood cell transfusion

MeSH Terms

Apgar Score
Ductus Arteriosus, Patent
Enterocolitis, Necrotizing
Erythrocyte Transfusion
Erythrocytes
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Logistic Models
Membranes
Parturition
Rupture