Influencing Factors Of Anemia In Extremely Low Birth Weight Infants

Objective:To investigate incidence of anemia in extremely low birth weight infants(ELBWI)in Hunan Children’s Hospital;to explore the influencing factors of anemia in ELBWI;to study the adverse effects of anemia in ELBWI.Method:All ELBWIs admitted to Hunan Children’s Hospital from January 1,2014 to December 31,2016,the admission age was less than72 hours,and hospitalization time was more than 7 days,were included.We observed general information,prenatal factors,birth conditions,postpartum factors,complications and blood transfusion treatment during hospitalization.Univariate analysis and multivariate Logistic regression analysis were conducted to explore risk factors of anemia in ELBWI.Results:1.From January 1,2014 to 31 December,2016,200 ELBWIs were admitted to our hospital.120 patients were male(60%),80 patients were female(40%);The range of gestational age was 24.1~34.7 weeks;range of birth weight was 500~995g.2.A total of 103 ELBWIs matched the inclusion criteria were included in this study,67 patients were male(65.0%),36 patients were female(35.0%);The range of gestational age was 24.1~34.7 weeks;range of birth weight was 500~995g.Anemia occurred in 98 patients(95.1%)during hospitalization;91 patients(88.4%)were transfused with red blood cells.74 patients(71.8%)had bronchopulmonary dysplasia,47patients(45.6%)had retinopathy of prematurity,54 patients(52.4%)had sepsis(including clinical diagnosis),11 patients(10.7%)had neonatal necrotizing enterocolitis,6(5.8%)patients had periventricular leukomalacia,47 patients(45.6%)had entrauterine growth restriction.42patients(40.8%)died.3.There were 72(69.9%)patients had anemia in 7 days of age after birth and 31(30.1%)patients had no anemia.Multivariate Logistic regression analysis showed that gestational age,maternal anemia,initial hemoglobin and the loss of blood volume for testing within 7 days of age were influencing factors of anemia in ELBWI within 7 days after birth(OR=0.613,p=0.018;OR=20.413,p=0.029;OR=0.941,P<0.001;OR=1.992,p=0.042).4.All 103 ELBWIs,84 patients had anemia when older than 7 days after birth.Among them,40 cases(47.6%)had mild or moderate anemia,44 cases(52.4%)had severe or extremely severe anemia.Multivariate Logistic regression analysis showed that gestational age,the time of anemia and the loss of blood volume for testing per weight within 7days after birth were influencing factors of severe or extremely severe anemia in ELBWI(OR=0.357,p=0.001;OR=0.653,p=0.001;OR=1.443,p<0.001).5.Compared with the group of ELBWI without anemia within 7days of age,the group ELBWI with anemia had longer time of invasive mechanical ventilation(z=-3.325,p=0.001),more blood transfusions(χ~2=-3.039,p=0.002)and larger amount of blood transfusion volume per weight(z=-3.432,p=0.001).Conclusions1.Small gestational age,maternal anemia,lower initial hemoglobin after birth and greater loss of blood for testing within 7 days of age were risk factors of anemia in ELBWI within 7 days after birth.2.Small gestational age,anemia begun early and big loss of blood volume for testing per weight within 7 days of age were risk factors of severe or extremely severe anemia in ELBWI after 7days of age.3.ELBWI with anemia within 7 days of age had longer time of invasive mechanical ventilation,more blood transfusions and larger amount of blood transfusion volume per weight...