Title |
Factors associated with red blood cell transfusions in very-low-birth-weight preterm infants in Brazilian neonatal units
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Published in |
BMC Pediatrics, September 2015
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DOI | 10.1186/s12887-015-0432-6 |
Pubmed ID | |
Authors |
Amelia Miyashiro Nunes dos Santos, Ruth Guinsburg, Maria Fernanda Branco de Almeida, Renato Soibelman Procianoy, Sergio Tadeu Martins Marba, Walusa Assad Gonçalves Ferri, Ligia MariaSuppo de Souza Rugolo, José Maria Andrade Lopes, Maria Elisabeth Lopes Moreira, Jorge Hecker Luz, Maria Rafaela Conde González, Jucille do Amaral Meneses, Regina Vieira Cavalcante da Silva, Vânia Olivetti Steffen Abdallah, José Luiz Muniz Bandeira Duarte, Patricia Franco Marques, Maria Albertina Santiago Rego, Navantino Alves Filho, Vera Lúcia Jornada Krebs, For the Brazilian Network on Neonatal Research |
Abstract |
Preterm infants in neonatal intensive care units frequently receive red blood cells (RBC) transfusions due to the anemia of prematurity. A number of variables related to gestational age, severity of illness and transfusion practices adopted in the neonatal unit where the neonate was born may contribute to the prescription of RBC transfusions. This study aimed to analyse the frequency and factors associated with RBC transfusions in very-low-birth-weight preterm infants. A prospective cohort of 4283 preterm infants (gestational age: 29.9 ± 2.9 weeks; birth weight: 1084 ± 275 g) carried out at 16 university hospitals in Brazil between January 2009 and December 2011 was analysed. Factors associated with RBC transfusions were evaluated using univariate and multiple logistic regression analysis. A total of 2208 (51.6 %) infants received RBC transfusions (variation per neonatal unit: 34.1 % to 66.4 %). RBC transfusions were significantly associated with gestational age (OR: -1.098; 95%CI: -1.12 to -1.04), SNAPPE II score (1.01; 1.00-1.02), apnea (1.69; 1.34-2.14), pulmonary hemorrhage (2.65; 1.74-4.031), need for oxygen at 28 days of life (1.56; 1.17-2.08), clinical sepsis (3.22; 2.55-4.05), necrotising enterocolitis (3.80; 2.26-6.41), grades III/IV intraventricular hemorrhage (1.64; 1.05-2.58), mechanical ventilation (2.27; 1.74-2.97), use of umbilical catheter (1.86; 1.35-2.57), parenteral nutrition (2.06; 1.27-3.33), >60 days of hospitalization (5.29; 4.02-6.95) and the neonatal unit where the neonate was born. The frequency of RBC transfusions varied among neonatal intensive care units. Even after adjusting for adverse health conditions and therapeutic interventions, the neonatal unit continued to influence transfusion practices in very-low birth-weight infants. |
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