title: Effects of Red Blood Cell Transfusions on the Risk of Developing Complications or Death: An Observational Study of a Cohort of Very Low Birth Weight Infants.
abstract: BackgroundThe aim of this study was to evaluate the association between red blood cell (RBC) transfusions on the risk of death, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants.Study Design and MethodsThis is an observational study. Data were entered prospectively into the study database at the time of the first transfusion. Clinical characteristics, adverse events, and outcomes of the patients transfused in the first 28 days of life were compared with the population of VLBW infants not transfused during the same period. The association among birth weight, gestational age, comorbidities, and the number of transfusions was estimated with a Poisson regression model. The association between the composite outcome and the occurrence of death, ROP, or BPD separately considered and a set of covariates was estimated with a logistic regression model.ResultsWe enrolled 641 VLBW infants, 42% of whom were transfused. Transfusions were associated with the risk of developing the composite outcome, independently from other conditions; this risk correlated with several transfusions ≥ 3 (odds ratio: 5.88, 95% confidence interval: 2.74-12.6). ROP and BPD were associated with several transfusions ≥ 3.ConclusionWe observed an association between RBC transfusions and the composite risk of death or ROP, BPD, and NEC.
authors.affiliation: Neonatal intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ghirardello
authors.affiliation: Neonatal intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Dusi
authors.affiliation: Department of Clinical Sciences and Community Health, Laboratory G. Maccacaro, Universita' degli Studi di Milano, Milano, Italy.
authors.forename: Ivan
authors.initials: I
authors.lastname: Cortinovis
authors.affiliation: Immunoheamatology and Transfusion Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Villa
authors.affiliation: Neonatal intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Fumagalli
authors.affiliation: Maternal and Child Health Department, Del Ponte Hospital, A.O. Di Circolo Fondazione Macchi, Varese, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Agosti
authors.affiliation: Department of Clinical Sciences and Community Health, Laboratory G. Maccacaro, Universita' degli Studi di Milano, Milano, Italy.
authors.forename: Silvano
authors.initials: S
authors.lastname: Milani
authors.affiliation: Neonatal intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000751:Anemia, Neonatal / Q000628:therapy*; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology*; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D066087:Perinatal Death; D012178:Retinopathy of Prematurity / Q000453:epidemiology*; D012307:Risk Factors