新生儿严重贫血、红细胞输血与坏死性小肠结肠炎的关联。
The association of severe anemia, red blood cell transfusion and necrotizing enterocolitis in neonates.
机构信息
Department of Neonatology, Henan Key Laboratory of Child Brain Injury and Henan Pediatrics Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience, Zhengzhou University, Zhengzhou, China.
Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
出版信息
PLoS One. 2021 Jul 20;16(7):e0254810. doi: 10.1371/journal.pone.0254810. eCollection 2021.
BACKGROUND
The relationship between severe anemia, red blood cell transfusion and Neonatal necrotizing enterocolitis (NEC) remains controversial. The purpose of this study was to determine the association of severe anemia and RBC transfusion with NEC in neonates.
METHODS
The clinical characteristics of NEC were observed in 467 infants with different birth weights from January 2012 to July 2020. A 1:1 ratio case-control study was performed in very low birth weight (VLBW) infants. Severe anemia, RBC transfusion, and confounding factors, including maternal and perinatal complications, feeding, and antibiotics administration were collected in both groups. Univariate and multivariate analyses were used to investigate effects on the risk of NEC.
RESULTS
The day of NEC onset and mortality were inversely associated with birth weight. In VLBW infants, adjusting for other factors, severe anemia within 72 h [OR = 2.404, P = 0.016], RBC transfusion within 24 h [OR = 4.905, P = 0.016], within 48 h [OR = 5.587, P = 0.008], and within 72 h [OR = 2.858, P = 0.011] increased the risk of NEC.
CONCLUSION
Both severe anemia and RBC transfusion appears to increase the risk of NEC in VLBW infants. The early prevention and treatment of anemia, strict evaluation of the indications for transfusion and enhanced monitoring after transfusion is encouraged in the NICU.
背景
严重贫血、红细胞输血与新生儿坏死性小肠结肠炎（NEC）之间的关系仍存在争议。本研究旨在确定严重贫血和 RBC 输血与新生儿 NEC 的关系。
方法
观察了 2012 年 1 月至 2020 年 7 月不同出生体重的 467 例婴儿的 NEC 临床特征。对极低出生体重（VLBW）儿进行了 1:1 的病例对照研究。收集了两组严重贫血、RBC 输血和围产期并发症、喂养、抗生素使用等混杂因素。采用单因素和多因素分析来探讨其对 NEC 风险的影响。
结果
NEC 发病日和死亡率与出生体重呈反比。在 VLBW 儿中，校正其他因素后，72 h 内严重贫血[OR=2.404，P=0.016]、24 h 内 RBC 输血[OR=4.905，P=0.016]、48 h 内[OR=5.587，P=0.008]和 72 h 内[OR=2.858，P=0.011]均增加了 NEC 的风险。
结论
严重贫血和 RBC 输血似乎都会增加 VLBW 儿 NEC 的风险。NICU 中应鼓励早期预防和治疗贫血，严格评估输血适应证，并加强输血后监测。
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