title: Relationship between Packed Red Blood Cell Transfusion and Severe Form of Necrotizing Enterocolitis: A Case Control Study.
abstract: OBJECTIVE
  To determine if packed red blood cell transfusion is associated with onset of necrotizing enterocolitis, and whether withholding feed has any association with it.
  
  
  METHODS
  Case records of 100 preterm neonates, (<34 weeks gestation) who developed necrotizing enterocolitis and 99 random age-and gestation-matched controls were evaluated for any blood transfusion 48 h before onset of necrotizing enterocolitis.
  
  
  RESULTS
  During the study period 26% infants received packed red blood cell transfusion within 48-hours prior to onset of disease and 84% of these infants were not fed around the time of transfusion. Infants who developed necrotizing enterocolitis after transfusion were older, of lower gestational age, birth weight and more likely to develop stage 3 disease. They had a lower hematocrit at birth and before onset of disease and withholding feeds around transfusion did not prevent necrotizing enterocolitis. Odds of mortality in these infants was 2.83 (95% CI 0.97-8.9) and survivors had no significant difference in incidence of periventricular leukomalacia and length of hospital stay.
  
  
  CONCLUSIONS
  Blood Transfusion associated necrotizing enterocolitis is a severe, mainly surgical form of disease.
authors.affiliation: Departments of Biostatistics and *Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC; and #Department of Pediatrics, Division Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio; USA. Correspondence to: Dr Prem Shekhawat, Department of Pediatrics, Division of Neonatology, MetroHealth Hospital, Case Western Reserve University, 2500 MetroHealth Drive, Room R 249A, Cleveland, Ohio 44109, USA. pshekhawat@metrohealth.org.
authors.forename: Parvesh M
authors.initials: PM
authors.lastname: Garg
authors.forename: Srikanth
authors.initials: S
authors.lastname: Ravisankar
authors.forename: Hui
authors.initials: H
authors.lastname: Bian
authors.forename: Scott
authors.initials: S
authors.lastname: Macgilvray
authors.forename: Prem S
authors.initials: PS
authors.lastname: Shekhawat
mesh_terms: D016022:Case-Control Studies; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005248:Feeding Methods; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007902:Length of Stay; D007969:Leukomalacia, Periventricular; D012189:Retrospective Studies