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Predictive factors and practice trends in red blood cell transfusions for very-low-birth-weight infants

Osayame A Ekhaguere1, Frank H Morriss2, Edward F Bell2

  • 1Department of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Pediatric Research
|January 13, 2016
PubMed

Insights

Red blood cell transfusions in very-low-birth-weight infants decreased over time. Higher initial hemoglobin levels and female sex were associated with fewer transfusions, while mechanical ventilation and necrotizing enterocolitis increased transfusion likelihood.

Area of Science:

  • Neonatal Medicine
  • Pediatric Hematology

Background:

  • Red blood cell (RBC) transfusions are common but carry risks for very-low-birth-weight (VLBW) infants.
  • Understanding predictors and trends is crucial for optimizing care.

Purpose of the Study:

  • To identify clinical predictors of RBC transfusions in VLBW infants.
  • To analyze trends in RBC transfusion practices over time.

Main Methods:

  • A single-center cohort study of 1,750 VLBW infants (birth weight ≤1,500 g).
  • Data analyzed across three epochs: 2000-2004, 2005-2009, and 2010-2013.
  • Statistical analysis to determine predictors and trends in RBC transfusion rates.

Main Results:

  • 67% of VLBW infants received at least one RBC transfusion.
  • Increased initial hemoglobin, higher birth weight, and female sex were associated with decreased transfusion likelihood.
  • Mechanical ventilation, longer hospital stay, necrotizing enterocolitis, and congenital anomalies increased transfusion likelihood.
  • The mean number of transfusions per patient decreased significantly in the latest epoch (2010-2013).

Conclusions:

  • RBC transfusion rates in VLBW infants have declined.
  • Female infants showed an unexplained protective effect against transfusions.
  • Strategies like increasing initial hemoglobin through placentofetal transfusion at delivery may reduce RBC transfusion needs.
Abstract

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