Abstract:

Objective To identify the risk factors of transfusion-associated necrotizing enterocolitis (TA-NEC) in very preterm infants. Methods The very premature infants admitted to the neonatal intensive care unit between April 2013 and April 2021 who received red blood cell transfusion were selected as the study subjects. The very premature infants meeting the inclusion criteria of the TA-NEC group were included in the TA-NEC group. Non-NEC very premature infants of the same gender, gestational age (±3 d), birth weight (±200 g) and transfusion age (±3 d) at the same time were matched as the control group at a ratio of 1∶2. The clinical characteristics between the two groups were compared to explore the risk factors of TA-NEC. Results A total of 204 very premature infants (138 boys and 66 girls) were included. The mean gestational age was (29.0±1.5) weeks, and the median birth weight was 1100.0 (951.0-1200.0) g. Sixty-eight patients were in the TA-NEC group and 136 in the control group. The multivariate conditional logistic regression analysis showed that fetal distress, chorioamnionitis and late-onset sepsis were independent risk factors of TA-NEC (P<0.05), and full oral feeding was an independent protective factor against TA-NEC (P<0.05) in very premature infants. Conclusions The very premature infants with fetal distress, chorioamnionitis and/or late-onset sepsis are more likely to develop NEC within 48hours after a transfusion of red blood cells. The prevention of perinatal hypoxia and sepsis and the completion of the transition to full oral feeding safely have a positive role in reducing the incidence of TA-NEC in very preterm infants.

Key words: transfusion-associated necrotizing enterocolitis, risk factor, very preterm infant