Red Blood Cell Transfusions at 21 Days of Age or Older in Previously Transfusion-Naive Very Preterm Infants: Association with Neonatal Outcomes.
OBJECTIVE
This study aims to assess the association of red blood cell (RBC) transfusion in a cohort of preterm infants with mortality, retinopathy of prematurity (ROP), and chronic lung disease (CLD) transfused at ≥21 days of life.


METHODS
This retrospective cohort study included infants born at <30 weeks' gestation who survived ≥21 days, had not received any RBC transfusions before reaching 21 days of age, and were admitted to participating units in the Canadian neonatal network (2003-2009).


RESULTS
Out of the 3,799 eligible infants, 3,309 infants did not receive RBC transfusion at  ≥21 days of age, whereas 490 received transfusion at  ≥21 days of age. Infants who did not receive RBC transfusion/s at  ≥21 days of age had higher birth weight (p<0.01) and higher gestational age at the time of birth (p<0.01) as compared with those who received transfusion/s at ≥21 days of age. Receipt of RBC transfusion/s at  ≥21 days of age was not associated with mortality (adjusted odds ratio [AOR] 1.20; 95% confidence interval [CI] 0.33-4.34) or severe ROP (AOR 1.02; 95% CI 0.59-1.77) but was associated with increased odds of CLD (AOR 1.78; 95% CI 1.43-2.22).


CONCLUSIONS
RBC transfusion/s at  ≥21 days of age in previously transfusion-naive preterm infants was associated with increased odds of CLD but not with ROP or mortality.
Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
Amy
A
Keir
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Khalid
K
Aziz
Department of Paediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Douglas
D
McMillan
Department of Paediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Luis
L
Monterrosa
Department of Paediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Cecil
C
Ojah
Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
Shoo
S
Lee
Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
Prakesh S
PS
Shah
D000367:Age Factors; D002170:Canada; D016009:Chi-Square Distribution; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D062071:Infant, Extremely Premature / Q000097:blood*; D007231:Infant, Newborn; D016015:Logistic Models; D008171:Lung Diseases / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D012178:Retinopathy of Prematurity / Q000453:epidemiology*; D012189:Retrospective Studies