Association between Anemia, Blood Transfusion and Necrotizing Enterocolitis in Very Low Birth Weight Infants: A Clinical Observational Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: 目的：探讨极低出生体重儿(VLBW)贫血、红细胞输血与坏死性小肠结肠炎(NEC)发生的关联，评估贫血程度和输血治疗对NEC发生风险的影响。方法：回顾性分析2017年1月至2024年9月青岛大学附属医院新生儿重症监护病房收治的200例VLBW患儿临床资料。根据是否发生NEC分为NEC组(n = 68)和对照组(n = 132)。收集患儿一般资料、血红蛋白水平、贫血分级、红细胞输血相关情况等。采用单因素分析和多因素Logistic回归模型分析贫血与输血相关因素对NEC发生的影响。结果：两组在出生体重、胎龄、性别、Apgar评分等一般资料方面差异无统计学意义(P > 0.05)。NEC组红细胞输血率(73.5% vs 46.2%)、输血总次数(2.3 ± 1.1 vs 1.5 ± 0.9)、输血总量(35.1 ± 10.5 ml/kg vs 26.8 ± 8.7 ml/kg)及输血后48小时内NEC发生率(26.5% vs 3.8%)均显著高于对照组(均P Objective: To investigate the association between anemia, red blood cell (RBC) transfusion, and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants, and to evaluate the impact of anemia severity and transfusion timing on NEC risk. Methods: A retrospective case-control study was conducted on 200 VLBW infants admitted to the NICU of the Affiliated Hospital of Qingdao University from January 2017 to September 2024. Patients were divided into the NEC group (n = 68) and the control group (n = 132) based on the occurrence of NEC. Clinical data including hemoglobin levels, anemia classification, and RBC transfusion history were collected. Univariate analysis and multivariate logistic regression were used to assess independent risk factors for NEC. Results: There were no significant differences in general characteristics such as gestational age, birth weight, sex, or Apgar scores between the two groups (P > 0.05). Compared with the control group, the NEC group had significantly higher RBC transfusion rates (73.5% vs 46.2%), transfusion frequency (2.3 ± 1.1 vs 1.5 ± 0.9), cumulative transfusion volume (35.1 ± 10.5 ml/kg vs 26.8 ± 8.7 ml/kg), and NEC onset within 48 hours post-transfusion (26.5% vs 3.8%) (all P < 0.05). The NEC group also had a higher incidence of severe anemia (25.0% vs 8.3%, P = 0.001) and a lower proportion of normal hemoglobin levels. Multivariate analysis identified RBC transfusion (OR = 2.85), severe anemia (OR = 1.42), earlier age at first transfusion (OR = 0.92), and lower birth weight (OR = 0.97) as independent risk factors for NEC (P < 0.05). Conclusion: Both anemia and RBC transfusion significantly increase the risk of NEC in VLBW infants. Early identification and appropriate management of severe anemia, as well as rational timing of transfusions, are essential to reduce NEC incidence and improve outcomes.
Source: Advances in Clinical Medicine
Author: 婉璐 刘
Language: English
Topic: Infant Nutrition and Health
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4411460277