Investigation And Analysis Of Anemia-related Factors And Transfusion Status In Premature Infants In NICU

Objective:This retrospective study analyzed the case data of premature infants hospitalized in the neonatal department of our hospital,explored the risk factors related to anemia and the status of blood transfusion.The aim is to improve the prognosis and quality of life of premature infants,and provide a clinical basis for prevention and treatment of anemia of premature infants.Methods:The study population comprised 197 infants with less than 48 hours after birth,admitted to the neonatal intensive care unit and hospitalization time was more than 7 days,from August 1,2018 to July 31,2019,including the differences of perinatal diseases between pregnant women,birth conditions of premature infants,diseases during hospitalization in NICU,clinical treatment and blood transfusion.Data were processed using SPSS26.0 statistical software,and enumeration data were compared between groups using x²test.Measurement data with non-normal distribution or uneven variance were expressed as median and quartile interval[M（P25,P75）],and non-parametric rank sum test.Logistic regression analysis was used to explore the risk factors of anemia in premature infants.Results:A total of 197 patients were included in this study,Among them,99 were male（50.3%）and 98 were female（49.7%）.The gestational age was 27⁺⁶～36⁺⁶w;the birth weight was 1020～3800g;they were divided into anemia group and control group according to whether anemia occurred.Anaemia in preterm infants at birth was negatively correlated with birth weight,gestational age,and initial hemoglobin correlation analysis（P<0.01）,and the difference was statistically significant.98 children（49.7%）developed anemia during hospitalization.In the perinatal situation,the anemia group conceived by assisted reproductive technology（57.1%）was significantly higher than the control group（38.4%）,and the maternal history of anemia during pregnancy（28.5%）was significantly higher than the control group（12.1%）,（P<0.05）.In terms of diseases during hospitalization after birth,the incidence of infection,respiratory distress syndrome,and coagulopathy was higher in the anemia group than in the non-anaemia group,with statistically significant differences,which were 75.5%vs39.4%and 61.2%vs 28.3%,29.6%vs 13.1%.The difference in the use of ventilator-assisted ventilation in clinical treatment was statistically significant,and the rates of mechanical ventilation were 53.1%vs 11.1%.Multivariate logistic results showed that basal hemoglobin value was a protective factor for anemia,and ventilator-assisted ventilation was a risk factor during hospitalization（OR=0.916,p<0.001;OR=16.511,p<0.001）.55 premature infants（27.9%）were treated with red blood cell transfusion anemia during hospitalization,with a birth weight of 1555g±352.86g,of which 31 were VLBW infants,27（87.1%）were treated with blood transfusion,and 28 premature infants with birth weight≥1500g were treated with blood transfusion（16.7%）;46 preterm infants with gestational age<32 weeks were included,36 patients were treated with blood transfusion（78.2%）,and 19 patients（12.6%）were treated with blood transfusion at gestational age≥32 weeks.During the hospitalization of VLBW children,the number of red blood cell transfusions was≥3 times in 14-cases（45.1%）,and the number of red blood cell transfusions was<3 times in 17-cases（54.8%）.There was no statistically significant difference between the incidence of NEC and basal hemoglobin in preterm infants who received multiple red blood cell infusions（≥3 blood transfusions）during hospitalization（p<0.05）.The difference is statistically significant.Conclusion:（1）The anemia rate of premature infants in our neonatal department in the past year is 49.5%,of which the transfusion rate（transfusion of red blood cells）is 27.7%.（2）Univariate analysis:gestational age,birth weight,basal hemoglobin value,anemia during pregnancy,pregnancy method（IVF）,infection,abnormal blood coagulation function,and neonatal respiratory distress syndrome are all related to premature infants factor.（3）In the multivariate logistic analysis,the basic hemoglobin value is a protective factor,and mechanical ventilation is a risk factor.Prenatal infants who use invasive mechanical ventilation after birth and the lower the basic hemoglobin value at birth are more likely to develop anemia during hospitalization.（4）The transfusion rate of children with VLBW is 87.1%.There may be a correlation between the development of BPD and blood transfusion in common adverse outcomes during hospitalization,but there is no clear evidence that blood transfusion is an independent risk factor for the development of BPD.Large samples and multicenter study to evaluate.In summary,it is necessary to prevent and treat early anemia in preterm infants.Minimizing the number of blood transfusions can reduce the incidence of BPD in preterm infants.