Analysis of risk factors associated with blood transfusion in preterm infants with gestational age＜32 weeks
Objective To explore the red blood cell(RBC)transfusion situation and its risk factors in preterm infants with gestational age(GA)＜32 weeks,and to provide clinical basis for reducing the blood transfusion rate of premature infants.Methods The clinical data of 130 premature infants with GA＜32 weeks admitted to Affiliated Hospital of Yangzhou University from January 2018 to December 2022 were retrospectively analyzed.They were divided into a blood transfusion group and a non-blood transfusion group based on whether they received blood transfusion or not.In the blood transfusion group,there were 30 males and 31 females,with a gestational age of(29.79±1.66)weeks.In the non-blood transfusion group,there were 36 males and 33 females,with a gestational age of(31.13±1.02)weeks.By comparing the general data,maternal information,diagnosis and treatment status,etc.,and the risk factors affecting blood transfusion in premature infants with GA＜32 weeks were analyzed through univariate and multivariate logistic regression analysis.Independent sample t test was used for the measurement data with normal distribution,rank sum test was used for the measurement data with skew distribution,and x2 test was used for the count data.Results Among the 130 preterm infants with GA＜32 weeks,61 cases were treated with blood transfusion,with an incidence of 46.92％.The results of univariate analysis showed that the gestational age,birth weight,hemoglobin(Hb)value at birth,hematocrit(HCT),and small-for date-infant ratio of the blood transfusion group were all lower than those of the non-blood transfusion group[(29.79±1.66)weeks vs.(31.13±1.02)weeks,(1 334.05±304.29)g vs.(1631.45± 245.64)g,(166.00±24.77)g/L vs.(184.43±19.00)g/L,(51.04±7.95)％vs.(56.35±6.37)％,9.84％(6/61)vs.23.19％(16/69)],with statistically significant differences(t=-5.450,-6.160,-4.689,and-4.164,x2=4.106;all P＜0.05).The amount of blood collection within 2 weeks after birth and the proportions of Apgar score 1 min after birth ≤7 points,mechanical ventilation,tracheal intubation,apnea,neonatal respiratory distress syndrome(NRDS),bronchopulmonary dysplasia(BPD),and neonatal necrotizing enterocolitis(NEC)in the blood transfusion group were all higher than those in the non-blood transfusion group[(28.63±8.25)ml/kg vs.(20.84±5.27)ml/kg,42.62％(26/61)vs.13.04％(9/69),95.08％(58/61)vs.60.87％(42/69),19.67％(12/61)vs.1.45％(1/69),68.85％(42/61)vs.34.78％(24/69),72.13％(44/61)vs.52.17％(36/69),21.31％(13/61)vs.1.45％(1/69),14.75％(9/61)vs.2.90％(2/69)],with statistically significant differences(t=6.324,x2=14.398,21.349,11.946,15.036,5.448,11.305,and 4.444;all P＜0.05).The time of parenteral nutrition,the time to reach adequate feeding,the time of oxygen inhalation,and the hospitalization time in the blood transfusion group were longer than those in the non-blood transfusion group[21.00(15.00,31.00)d vs.11.00(8.00,17.00)d,23.00(17.00,33.00)d vs.12.00(9.00,17.50)d,10.00(4.00,28.00)d vs.3.00(0,6.00)d,(47.46±19.34)d vs.(27.62±8.78)d],with statistically significant differences(Z=-5.922,-6.075,and-5.687,t=7.368;all P＜0.05).Multivariate logistic regression analysis showed that birth weight＜1 500 g,amount of blood collection ≥25 ml within 2 weeks after birth,parenteral nutrition time ≥14 days,and use of mechanical ventilation were all independent risk factors for blood transfusion in preterm infants with GA＜32 weeks(OR=4.243,3.462,7.42 5,and 7.218,all P＜0.05),while Hb ≥160 g/L at birth was a protective factor(OR=0.072,P＜0.05).Conclusion Hb ≥160 g/L at birth is a protective factor for blood transfusion in premature infants with GA＜32 weeks,while birth weight＜1 500 g,blood collection volume ≥25 ml within2weeks after birth,parenteral nutrition time ≥14 days,and use of mechanical ventilation are independent risk factors for blood transfusion in premature infants with GA＜32 weeks.
万方数据
维普
