Red Blood Cell Transfusion and Neurodevelopmental Outcome in Preterm Infants

Author(s): Shahana Akter, Mohammad Golam Sadik, Md. Arif Hossain, M A Mannan

Background: Preterm neonates are the most commonly transfused group of patients and about 70-80% of preterm low birth weight infants receive transfusion. Blood transfusions are a common form of supportive therapy for sick neonatesand remain as an important life-saving intervention for neonatal intensive care patients. Red blood cell (RBC) transfusions provide an immediate increase in tissue oxygenation.

Objective: To assess the neurodevelopmental outcome of preterm infants who receive packed red blood cell transfusion.

Methodology: This prospective observational study was conducted in the Department of Neonatology, BSMMU, Dhaka, Bangladesh after approval by Institutional Review Board, over eighteen-month period. All Preterm low birth weight neonate satisfying the inclusion criteria were enrolled in the study. All patient managed as per standard clinical guidelines of NICU, BSMMU, Dhaka, Bangladesh. PRBC transfusion was given according to institutional protocol. We included total 60 infants, were divided in to two groups on the basis of PRBC transfusion. 29 infants were in PRBC group and 31 in non PRBC group. The hospital outcomes were recorded as necrotizing enterocolitis (NEC), Broncho pulmonary dysplasia (BPD) and Retinopathy of prematurity (ROP). Detailed neurodevelopmental assessment was done at 6 and 9 months of postnatal age, using Bayley Scales of Infant Development Third edition, in the Institute of Pediatric Neurodisorder and Autism (IPNA). Data were analyzed using the statistical package for social sciences (SPSS) version 25. P value < 0.05 is considered as statistically significant.

Results: Total 60 preterm low birth weight patients completed neurodevelopmental follow up. Among them 29 (48.3%) patients who received PRBC and 31 (51.7%) patients who did not receive PRBC transfusion. Mean gestational age was 32.75 weeks and mean birth weight was 1503.33 g

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