Analysis of risk factors for neonatal transfusion-associated necrotizing enterocolitis

Objective To investigate the clinical relevant factors associated with transfusion associated necrotizing enterocolitis (TANEC) in order to reduce the incidence of neonatal necrotizing enterocolitis (NEC). Methods The clinical data of neonates admitted to the First Hospital of Lanzhou University and received blood transfusion therapy from January 2017 to June 2018 were collected, including perinatal factors, basic conditions of children, and comorbidities.According to the occurrence or absence of NEC within 48 hours after transfusion, the patients were divided into TANEC group and no-TANEC group.The clinical data of the two groups were compared. Results Univariate analysis showed that there were statistical differences (P<0.05) in the mode of delivery, gestational age, birth weight, neonatal sepsis, patent ductus arteriosus(PDA), neonatal respiratory distress syndrome (NRDS), and anemia.The logistic multivariate analysis revealed that gestational age(P<0.05, OR=0.772, 95%CI: 0.684-0.871), the birth weight(P<0.05, OR=0.236, 95%CI: 0.079-0.711)were protect fators of TANEC, the degree of anemia(mode 1: P<0.05, OR=3.129, 95%CI: 1.003-9.756; mode 2: P<0.05, OR=3.449, 95%CI: 1.024-11.609)and sepsis (mode 1: P<0.05, OR=6.327, 95%CI: 1.732-23.720; mode 2: P<0.05, OR=8.154, 95%CI: 2.122-31.336)were significant risk fators for TANEC. Conclusion The factors leading to the occurrence of TANEC are various.When transfused, the greater the gestational age, the higher the birth weight, the lower the risk of developing NEC.The more severe the combination of neonatal sepsis and anemia, the higher the risk of developing TANEC.Clinically, comprehensive measures should be taken to prevent neonatal anemia.According to the specific conditions of the children and the degree of anemia, a reasonable clinical strategy should be formulated to avoid blood transfusion to reduce the incidence of TANEC and improve the prognosis of the children. Key words: Neonate; Anemia; Blood transfusion; Transfusion-associated necrotizing enterocolitis; Sepsis