Enteral iron supplementation, red blood cell transfusion, and risk of bronchopulmonary dysplasia in very‐low‐birth‐weight infants
| Autor: | Jing Yang, Michael Hinkes, Cassandra D. Josephson, Neeta Shenvi, Kirk A. Easley, Andrea Knezevic, Ravi Mangal Patel, John D. Roback |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Iron Immunology 030204 cardiovascular system & hematology Enteral administration Article Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors mental disorders medicine Humans Infant Very Low Birth Weight Multicenter Studies as Topic Immunology and Allergy Blood Transfusion Prospective Studies Risk factor Bronchopulmonary Dysplasia Retrospective Studies Cumulative dose business.industry Infant Newborn Infant Reproducibility of Results Gestational age Retrospective cohort study Lung Injury Hematology medicine.disease Low birth weight Bronchopulmonary dysplasia Relative risk Multivariate Analysis Female medicine.symptom Erythrocyte Transfusion business 030215 immunology |
| Zdroj: | Transfusion |
| ISSN: | 1537-2995 0041-1132 |
| Popis: | BACKGROUND: Enteral iron supplementation and red blood cell (RBC) transfusions are routinely administered to very low birth weight infants (VLBW), although the potential risks of these exposures have not been adequately quantified. This study evaluated the association between the cumulative dose of enteral iron supplementation, total volume of RBC transfused and risk of bronchopulmonary dysplasia (BPD) in VLBW infants. STUDY DESIGN AND METHODS: Retrospective, multicenter observational cohort study in Atlanta, GA. Cumulative supplemental enteral iron exposure and total volume or RBC transfused were measured until the age at assessment of BPD. Multivariable generalized linear models used to control for confounding and the reliability of the factors assessed in 1000 bootstrap models. RESULTS: A total of 598 VLBW infants were studied. In multivariable analysis, a greater cumulative dose of supplemental enteral iron exposure was associated with an increased risk of BPD (adjusted relative risk per 50mg increase: 1.07, 95% CI 1.02–1.11; P=0.002). Similarly, a greater volume of RBC transfused was associated with a higher risk of BPD (adjusted relative risk per 20 ml increase: 1.05, 95% CI 1.02–1.07; P 50%). Volume of RBC transfused was similar to gestational age in reliability as a risk factor for BPD (present in 100% of models) and was more reliable than mechanical ventilation at 1 week of age. CONCLUSION: The cumulative dose of supplemental enteral iron exposure and total volume of RBC transfusion are both independently associated with an increased risk of BPD in VLBW infants. |
| Databáze: | OpenAIRE |
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