Severe anemia significantly increases the rate of necrotizing enterocolitis (NEC) in infants with very low-birth-weight (VLBW), new research shows.
Ravi M. Patel, MD, MSc, and his team of researchers at Emory University School of Medicine, in Atlanta, studied the potential relationship between NEC and VLBW infants who had red blood cell transfusions and severe anemia. They found that severe anemia was a greater risk factor for NEC than for those who did not have severe anemia (adjusted cause-specific hazard ratio, 5.99 [95% CI, 2.00-18.0]; P=.001).
NEC is the leading cause of death among preterm infants, with a mortality rate of at least 50%, according to Medscape. How NEC originates and develops is largely unknown. However, because more than half of VLBW infants receive one or more transfusions during hospitalization, more information is needed on risk factors for the condition, according to Dr. Patel.
The latest study included data from 600 VLBW infants, who were about five days old and weighed less than three pounds. Of those, 44 developed NEC and 32 died. Each infant was followed for 90 days or until they were discharged or transferred from the hospital, or died.
Dr. Patel said that preventing severe anemia may be more important for decreasing the risk of NEC than reducing RBC transfusion exposures.
“Among very low-birth-weight infants, severe anemia but not red blood cell transfusion was associated with an increased risk for necrotizing enterocolitis,” Dr. Patel and his colleagues wrote. “Ongoing clinical trials comparing liberal versus conservative transfusion practices may provide additional experimental data regarding the risks of both severe anemia and RBC transfusion to NEC.”
Dr. Patel’s group reported their findings in JAMA.