Risk Factors Of Blood Transfusion In Very Low Birth Weight Infants

Objective:We aimed to study the characteristics and risk factors for blood transfusion in very low birth weight infants(VLBWI).Methods:Clinical data of 100 VLBWI,hospitalized from July,2016 to June,2019,were studied retrospectively.The infants were divided into two group according to whether they received blood transfusion.Two groups were compared with general information,diseases in hospital and treatment taken,and analyze the risk factors influencing the blood transfusion.Results:1.Of the 100 VLBWI,the mean gestational age and birth weight were 31.3±2.5 weeks(range:26.1~36.9weeks)and 1300.7±185.6g(range:750~1490g).69 cases need blood transfusion,the infusion consisted of suspended red blood cells,the first time to blood transfusion ranged from 1 to 4 weeks after birth,the average number of transfusions was 6,the amount of each transfusion is 10~15mL/kg.2.Maternal anemia during pregnancy,birth weight,gestational age,hemoglobin and hematocrit at birth,volume of blood taking within 2 weeks after birth,duration of hospitalization,duration of paraenteral nutrition,delivery method,need for intubation and neonatal respiratory distress syndrome,apnea,bronchopulmonary dysplasia,patent ductus arteriosus showed significant difference between two groups(P<0.05).3.The risk of needing RBC transfusion increased by 2.85(1.03~7.83)times for infants with a birth weight of less than 1250g(P=0.043),compared to infants of birth weight equal to or greater than 1250g.The risk of RBC transfusion increased by16.54(5.12~58.38)times in VLBWI whose duration of paraenteral nutrition was equal to or longer than three weeks(P<0.001).The risk also increased by 5.53(2.09~14.63)times in patients whose volume of blood taking within 2 weeks after birth was equal to or longer than 15mL/kg~-than blood loss less 15mL/kg(P<0.001).4.Logistic regression analysis revealed that lower gestation(OR=0.386,95%CI:0.212~0.704,P=0.002),longer duration of hospital stay(OR=2.177,95%CI:1.170~4.049,P=0.014)and prolonged parenteral nutrition(OR=1.195,95%CI:1.083~1.319,P<0.001),greater volume of blood taking within 2 weeks after birth and cesarean delivery are associated with increased risk of blood transfusion in VLBW infants.Conclusion:1.The transfusion indication of VLBWI is influenced by many factors.The gestational age,length of hospital stay,blood intake within 2 weeks after birth,duration of paraenteral nutrition and delivery method are independent predictors of blood transfusion.2.RBC transfusion of VLBWI is associated with increased risk of apnea,neonatal respiratory distress syndrome,bronchopulmonary dysplasia,patent ductus arteriosus.