Do red cell transfusions increase the risk of necrotizing enterocolitis in premature infants?

Journal Article (Journal Article)

OBJECTIVE: To test the hypothesis that red blood cell (RBC) transfusions increase the risk of necrotizing enterocolitis (NEC) in premature infants, we investigated whether the risk of "transfusion-associated" NEC is higher in infants with lower hematocrits and advanced postnatal age. STUDY DESIGN: Retrospective comparison of NEC patients and control patients born at < 34 weeks gestation. RESULTS: The frequency of RBC transfusions was similar in NEC patients (47/93, 51%) and control patients (52/91, 58%). Late-onset NEC (> 4 weeks of age) was more frequently associated with a history of transfusion(s) than early-onset NEC (adjusted OR, 6.7; 95% CI, 1.5 to 31.2; P = .02). Compared with nontransfused patients, RBC-transfused patients were born at earlier gestational ages, had greater intensive care needs (including at the time of onset of NEC), and longer hospital stay. A history of RBC transfusions within 48-hours before NEC onset was noted in 38% of patients, most of whom were extremely low birth weight infants. CONCLUSIONS: In most patients, RBC transfusions were temporally unrelated to NEC and may be merely a marker of overall severity of illness. However, the relationship between RBC transfusions and NEC requires further evaluation in extremely low birth weight infants using a prospective cohort design.

Full Text

Duke Authors

Cited Authors

  • Josephson, CD; Wesolowski, A; Bao, G; Sola-Visner, MC; Dudell, G; Castillejo, M-I; Shaz, BH; Easley, KA; Hillyer, CD; Maheshwari, A

Published Date

  • December 2010

Published In

Volume / Issue

  • 157 / 6

Start / End Page

  • 972-978.e1-3 -

PubMed ID

  • 20650470

Pubmed Central ID

  • PMC4425198

Electronic International Standard Serial Number (EISSN)

  • 1097-6833

Digital Object Identifier (DOI)

  • 10.1016/j.jpeds.2010.05.054


  • eng

Conference Location

  • United States