Neurologic Outcomes in Neonates Following the Introduction of a Restrictive Transfusion Guideline

Objective: To evaluate the neurodevelopmental outcomes of very low birthweight (VLBW) infants before and after the introduction of a restrictive transfusion guideline. Study design: This is a large retrospective study comparing neurodevelopmental outcomes before and after a restrictive transfusion guideline (RTG) was established for VLBW infants admitted to a large single neonatal intensive care unit (NICU). Bayley-III scores obtained from routine NICU follow up appointments at pediatric neurodevelopmental clinics were evaluated. The mean age of obtaining the Bayley-III score was 20.3 months with a standard deviation of +/- 5.2 months. Results: Neurodevelopmental outcomes measured by Bayley-III scores, were similar for cognitive, language, and motor testing in the RTG versus LTG groups. In addition, the subcategories for normal, mild delay, moderate delay and severely delayed were also similar. Conclusion: RTG is safe in the neonatal VLBW population. RTG when compared to liberal transfusion guideline (LTG) is associated with similar neurodevelopmental outcomes as defined by Bayley-III scores.