Necrotizing enterocolitis is the leading cause of mortality in preterm infants. Although there is conflicting evidence, red blood cell (RBC) transfusions and/or anemia may be risk factors for necrotizing enterocolitis.
Since transfusions are often used to treat anemia, researchers evaluated RBC transfusions and anemia in 598 very low-birth-weight (VLBW) infants at risk for necrotizing enterocolitis in three Atlanta hospitals. Forty-four (7.4%) infants were diagnosed with necrotizing enterocolitis, and 32 (5.4%) died (all causes). Slightly over half (N = 319, 53%) of the infants received RBC transfusions; however, transfusions were not significantly associated with a risk of necrotizing enterocolitis (adjusted hazard ratio=0.44 [95% CI, 0.17-1.12]). The rate of necrotizing enterocolitis among VLBW infants with severe anemia (hemoglobin < 8 g/dL) was significantly higher than those who did not have severe anemia (adjusted hazard ratio, 5.99 [95% CI, 2.00-18.00]). Further studies are needed to assess the risk of necrotizing enterocolitis in preterm infants with severe anemia.