[Meta-analysis of post-transfusion necrotizing enterocolitis in neonates].
OBJECTIVE
To quantitatively assess the association between transfusions and the risk of necrotizing enterocolitis (NEC) in neonates.


METHODS
Both Chinese and English literature published from Jan. 1985 to Nov. 2011 about the case-control study of the association between transfusions and neonatal NEC were retrieved by searching the electronic resource databases. A meta-analysis was then performed on the comparison and synthesis of findings from included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using RevMan 5.0 software. Sensitivity analysis was conducted and possible publication bias was tested as well.


RESULTS
A total of 7 case-control studies (480 blood transfusion cases, 2845 control cases) were included. The meta-analysis with a random-effects model found a pooled OR of 3.35 (95% CI: 1.54-7.27). Sensitivity analysis showed that OR for post-transfusion NEC within 48 h was 4.21 (95% CI: 2.17-8.16). The OR was 4.29 (95% CI: 1.39-13.24) after factors such as gestational age and birth weight were de-confounded. The fail-safe number was 263.


CONCLUSIONS
Blood transfusion can increase the risk of NEC in neonates. The clinical application of this conclusion should be cautious due to limited reports. High-quality randomized control trials are still needed for the further proof of the association between blood transfusion and neonatal NEC.
Department of Pediatrics, the Third Xiangya Hospital of Central South University,Changsha 410013, China.
Hui-Kang
HK
Tao
Qin
Q
Tang
Ming-Yan
MY
Hei
Bo
B
Yu
D015982:Bias; D016022:Case-Control Studies; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D007234:Infant, Premature; D063369:Knowledge Discovery; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D065227:Transfusion Reaction