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Severe Anemia Is Associated with Necrotizing Enterocolitis, not RBC Transfusions

March 9, 2016

small premature baby lies in an incubator a grown hand reaches in grasping the foot in caring manner

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.

 

 

Reference

  1. Patel RM, Knezevic A, Shenvi N, Hinkes M, Keene S, Roback JD, Easley KA, Josephson CD. Association of Red Blood Cell Transfusion, Anemia, and Necrotizing Enterocolitis in Very Low-Birth-Weight Infants. JAMA 2016;315: 889-97.

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