Necrotizing enterocolitis and mortality after transfusion of ABO non‐identical blood
| Autor: | Christoph Fusch, Tara Mcdougall, Michael K. Parvizian, Ziad Solh, Rebecca Barty, Amit Mukerji, Na Li, Nancy M. Heddle |
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| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Blood transfusion Birth weight medicine.medical_treatment Immunology Blood Component Transfusion Gestational Age Infant Newborn Diseases Cohort Studies Plasma Enterocolitis Necrotizing Risk Factors Intensive care ABO blood group system medicine Humans Infant Very Low Birth Weight Immunology and Allergy Hospital Mortality Neonatology Retrospective Studies business.industry Hazard ratio Infant Newborn Hematology medicine.disease digestive system diseases Necrotizing enterocolitis business Cohort study |
| Zdroj: | Transfusion. 61:3094-3103 |
| ISSN: | 1537-2995 0041-1132 |
| Popis: | Background The relationship between ABO non-identical transfusion and the outcomes of necrotizing enterocolitis (NEC), and all-cause mortality in very-low birth weight (VLBW) neonates receiving red blood cell transfusion is unknown. Study design and methods A retrospective multicenter cohort study was conducted in VLBW neonates in neonatal intensive care units between 2004 and 2016. VLBW (≤1500 grams) neonates were followed until discharge or in-hospital death. The primary exposure was ABO group. Secondary exposures included platelet count, plasma transfusions, and maternal ABO group. Outcome measures were NEC (defined as Bell stage ≥ 2) and all-cause mortality. Time-dependent Cox regression models with competing risks were used to investigate factors associated with NEC and mortality. Results Thousand and sixteen neonates were included with 10.8% developing NEC (n = 110) and 14.1% mortality (n = 143). Platelet count (hazard ratio [HR] = 0.995; 95% confidence interval [CI]: 0.922-0.998) and number of plasma transfusions (HR = 2.908; 95% CI:1.265-6.682) were associated with NEC, while ABO group (non-O vs. O) was not (HR = 0.761; 95% CI: 0.393-1.471). Higher all-cause mortality occurred in neonates without NEC who were non-O compared with O (HR = 17.5; 95% CI: 1.784-171.692), but not in neonates with NEC (HR = 1.112; 95% CI: 0.142-8.841). Plasma transfusion was associated with increased mortality in both groups. Discussion ABO non-identical transfusion was not associated with NEC or mortality in neonates with NEC. It was associated with increased mortality in neonates without NEC. As many neonatal intensive care units transfuse only O group blood as routine practice, future trials are needed to investigate the association between this practice and neonatal mortality. |
| Databáze: | OpenAIRE |
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