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  • Title: Retrospective case-control study of necrotizing enterocolitis and packed red blood cell transfusions in very low birth weight infants.
    Author: Crabtree CS, Pakvasa M, Radmacher PG, Adamkin DH.
    Journal: J Neonatal Perinatal Med; 2018; 11(4):365-370. PubMed ID: 30149467.
    Abstract:
    OBJECTIVE: The study objective was to explore the relationship between necrotizing enterocolitis (NEC) and packed red blood cell (pRBC) transfusion in very low birth weight (VLBW) neonates (<1500 g). STUDY DESIGN: A six-year retrospective chart review of VLBW infants with NEC (Bell's Stage > II) and a pRBC transfusion within 48 hours of diagnosis. Prenatal data, postnatal course, transfusion history, and NEC outcomes were reviewed. The transfusion associated necrotizing enterocolitis (TANEC) cases were matched with controls (1:2) who were transfused but did not develop NEC as to proximity of birth date, gestational age, and receipt of transfusion. RESULTS: Of 1139 VLBW admissions, there were 73 cases of NEC and 30 cases of TANEC (annual NEC rate 6.4%). TANEC cases were matched with 60 controls who were transfused but never developed NEC. Neonatal profiles were similar between all 3 groups, except for a higher proportion of infants <10th percentile in the non-TANEC group. Days of antibiotics and frequency of patient ductus arteriosus (PDA) ligation were lower in controls compared to NEC cases. Lower feeding rate at diagnosis of NEC/match were more common in control infants compared to TANEC infants. However, feeding abstinence rates were similar between the two groups. The number of transfusions prior to diagnosis/match was similar in all groups. There was no significant difference in pre-transfusion hematocrit values between the groups. CONCLUSION: TANEC was common among NEC cases. PDA ligation was similar among TANEC and non-TANEC but lower in controls. Similar pre-transfusion hematocrits were found among TANEC and controls. Feeding abstinence rates were also similar between TANEC and controls.
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