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Severe anemia ups risk of fatal intestinal disease in preterm infants

Posted:  Wednesday, March 09, 2016

Greater risk of necrotizing enter colitis (NEC) in very low birth weight (VLBW) infants with severe anemia! NEC is a fatal acute inflammatory disease affecting the intestines of premature infants. A new study finds that severe anemia increases the rate of NEC in VLBW infants.

The study, published in the journal JAMA, looked at the potential relationship of NEC with red blood cell (RBC) transfusion and severe anemia in VLBW infants. The researchers enrolled 600 VLBW infants within 5 days of birth from 3 neonatal intensive care units in Atlanta. The infants were followed up for 90 days during hospital stay or until hospital discharge or transfer to a non-study-affiliated hospital, or death, whichever came first.

The study indicated that forty-four (7.4%) infants developed NEC and 32 (5.4%) infants died from all causes. Three hundred and nineteen (53%) infants received a total of 1430 RBC transfusions. The study found that the rate of NEC was significantly greater among VLBW infants with severe anemia compared to those without severe anemia. However, red blood cell transfusion was not significantly linked to the NEC rate.

NEC is a leading cause of death among preterm infants; it is responsible for case-fatality rates of 20%-30 %. However, the cause and development of NEC are not clearly understood. Moreover, data on the role of RBC transfusion and anemia in NEC are conflicting. Current studies comparing conservative versus liberal transfusion practices may provide additional information on the risks of both RBC transfusion and severe anemia to NEC.

Elaborating on the study outcomes, the researchers said, "Because severe anaemia, but not RBC transfusion, was a risk factor for NEC in this study, preventing severe anaemia may be more clinically important than minimising RBC transfusion exposure as a strategy to decrease the risk of NEC. However, the effect of such a strategy on other important neonatal outcomes is unclear, and further study is needed. "

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