title: Analysis of the association between necrotizing enterocolitis and transfusion of red blood cell in very low birth weight preterm infants.
abstract: OBJECTIVE
  To investigate the association between necrotizing enterocolitis (NEC) and red blood cell transfusions in very low birth weight (VLBW) preterm infants.
  
  
  METHODS
  We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell's criteria) and a control group (less than stage II on the modified Bell's critieria). We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18) in the NEC group and the frequency of transfusion until 18 days after birth in the control group.
  
  
  RESULTS
  Of the 180 subjects, 18 (10%) belonged to the NEC group, and 14 (78%) of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received 3.1±2.9 transfusions, and the control group received 1.0±1.1 transfusions before the NEC diagnosis (P=0.005). In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P=0.007) with transfusion before the NEC diagnosis.
  
  
  CONCLUSIONS
  The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Seon-Yeong
authors.initials: SY
authors.lastname: Bak
authors.forename: Sihyoung
authors.initials: S
authors.lastname: Lee
authors.forename: Jae-Hong
authors.initials: JH
authors.lastname: Park
authors.forename: Kyu-Hee
authors.initials: KH
authors.lastname: Park
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Jeon
keywords: Necrotizing enterocolitis; Red blood cell transfusion; Very low birth weight infants
references.citation: Am J Public Health. 1997 Dec;87(12):2026-31
references.pmid: 9431297
references.citation: Pediatr Clin North Am. 1986 Feb;33(1):179-201
references.pmid: 3081865
references.citation: Clin Perinatol. 1994 Jun;21(2):205-18
references.pmid: 8070222
references.citation: Proc Natl Acad Sci U S A. 2007 Oct 23;104(43):17058-62
references.pmid: 17940022
references.citation: Acta Paediatr Suppl. 2005 Oct;94(449):100-5
references.pmid: 16214774
references.citation: J Pediatr. 2010 Nov;157(5):751-6.e1
references.pmid: 20598317
references.citation: Pediatrics. 2012 Mar;129(3):529-40
references.pmid: 22351894
references.citation: Am J Perinatol. 2008 Feb;25(2):111-8
references.pmid: 18236362
references.citation: Eur J Pediatr Surg. 2011 Jan;21(1):58-64
references.pmid: 21157690
references.citation: Curr Opin Infect Dis. 2003 Aug;16(4):349-55
references.pmid: 12861088
references.citation: Pediatr Dev Pathol. 2003 Jan-Feb;6(1):6-23
references.pmid: 12424605
references.citation: J Pediatr. 2010 Dec;157(6):972-978.e1-3
references.pmid: 20650470
references.citation: Pediatrics. 2011 Apr;127(4):635-41
references.pmid: 21402638
references.citation: Am J Surg. 1981 May;141(5):562-7
references.pmid: 6784586
references.citation: J Pediatr. 1976 Sep;89(3):467-70
references.pmid: 784926
references.citation: Semin Neonatol. 2003 Dec;8(6):449-59
references.pmid: 15001117
references.citation: J Pediatr. 1976 Sep;89(3):460-2
references.pmid: 956975
references.citation: J Pediatr. 1979 Sep;95(3):450-3
references.pmid: 469674
references.citation: Pediatrics. 1995 Jan;95(1):1-8
references.pmid: 7770284
references.citation: Klin Padiatr. 2012 Jul;224(4):276-81
references.pmid: 22441803
references.citation: J Pediatr. 2011 Mar;158(3):403-9
references.pmid: 21067771
references.citation: Indian J Pediatr. 2006 Nov;73(11):1011-8
references.pmid: 17127784
references.citation: J Paediatr Child Health. 2005 Apr;41(4):174-9
references.pmid: 15813870