Red blood cells transfusions in very low birth weight neonates

Abstract

Introduction: Very low birth weight preterm infants are associated with a greater risk of morbidity and mortality and are more susceptible to therapy with red blood cells transfusions. The aim of this study is to analyse the frequency and factors associated with red blood cells transfusions in very low birth weight infants.

Material and methods: This retrospective study included neonates with very low birth weight admitted between November 1, 2011 and October 31, 2015. Demographic, perinatal and clinical data during hospitalization were obtained through medical records. Statistical tests were used to compare neonates with and without need for red blood cells transfusion and multivariate regression analysis to find predictor factors.

Results: Seventy-nine patients were studied, median birth weight of 1,190 grams and mean gestational age of 29 ± 2 weeks. Forty-nine (62%) received transfusion support with red blood cells. Higher need for red blood cells transfusions was significantly associated with low birth weight (OR = 0.99, 95% CI 0.990-0.999) and total millilitres of phlebotomy losses (OR = 1.17, 95% CI 1.07-1.28). Birth weight (B = -0.01, 95% CI -0.008 to -0.003), hemoglobin at admission (B = -0.33, 95% CI -0.53 to -0.13) and sepsis (B = 1.85, 95% CI 0.72-2.98) were predictive factors for the number of red blood cells transfusions. Regarding the treatment with erythropoietin, there were no differences for all outcomes.

Conclusions: Phlebotomy losses are one of the major factors for the need of transfusion in preterm infants, and therefore sampling should be minimized to the maximum.