血小板输血和死亡或神经发育障碍在极度早产的儿童
Patricia E Davenport1, Thomas R Wood2,3, Patrick J Heagerty4
1Division of Newborn Medicine, Boston Childrens Hospital, Boston, Massachusetts.
JAMA network open
|January 23, 2024
概括
在极度早产的婴儿中,血小板输血可能会增加到2岁时死亡或严重神经发育障碍 (NDI) 的风险. 这一发现需要进一步调查高风险新生儿的输血实践.
科学领域:
- 新生儿医学 新生儿医学
- 儿科神经学 儿科神经学
- 血液学 血液学 血液学
背景情况:
- 出生极早的婴儿经常接受血小板输血,因为担心内出血.
- 以前的研究表明,更高的输血门可能与不良的神经发育结果有关.
研究的目的:
- 评估血小板输血暴露与2岁时死亡或严重神经发育障碍 (NDI) 之间的关联.
- 为了评估接受输血的极度早产婴儿的风险.
主要方法:
- 观察性队列研究和二次分析的前期红蛋白神经保护试验.
- 包括819名在怀孕24-27周出生的婴儿.
- 使用共变量调整和倾向得分方法来解决混.
主要成果:
- 30%的婴儿至少接受过一次血小板输血.
- 血小板输血与死亡或严重NDI的几率增加了2.43倍 (调整的OR,2.43;95%CI,1.24-4.76).
- 死亡和严重NDI的个体结果显示出一致的趋势.
结论:
- 在极度早产婴儿的血小板输血可能与死亡或严重NDI的风险增加有关.
- 不能排除由指示造成残留混的可能性.
- 研究结果表明,需要重新评估当前的输血门和做法.
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