BACKGROUNDIn neonates, several maternal and prenatal factors can contribute to anaemia in preterm infants. Assessing those determinants can help in planning transfusion in an effective manner. We wanted to identify the maternal and prenatal determinants of red blood cell transfusion in sick neonates.
METHODSThis was a case control study done on 300 neonates (150 cases and 150 controls). Study sample included newborn babies with gestational age less than 37 weeks and/or birth weight less than 2500 grams admitted to the Neonatal Intensive Care Unit (NICU) of Sri Avittom Thirunal Hospital, Government Medical College Thiruvananthapuram. Study was done for a period of one and a half years, in the Department of Transfusion Medicine, Government Medical College, Thiruvananthapuram. Cases were sick neonates who were transfused with packed red cells. Controls were sick neonates who did not receive packed cells. Maternal demographic characteristics known to be associated with anaemia of prematurity were analysed. Statistical data was analysed using SPSS software version 16.
RESULTS
46.7 % of mothers were primi gravida. 39.7 % were second gravida and 13.7 % were third gravida. Mean age at delivery was 25.5 +/-4.2. 43.3 % in the case group and 34.7 % in the control group delivered by caesarean section. On analysis, 88% in the case group had comorbid conditions compared to 81.3 % in the control group and was not statistically significant. 82 % of the case group had antenatal complications compared to 66 % in the control group and was statistically significant. 56.7 % of cases and 50 % of controls received steroids in the antenatal period and there was no statistically significant difference between the two groups.
CONCLUSIONSAmong the various ante-natal factors compared between case and control groups, ante-natal complications in general and PIH in specific was found to be a risk factor for RBC transfusion. BACKGROUND In neonates, blood loss, increased red cell destruction as in abnormalities of red cell membrane, decreased red cell production, obstetrical causes leading to blood loss, foetomaternal transfusion, twin-twin transfusion, internal haemorrhage, iatrogenic causes etc., are the factors leading to blood transfusions. Oxidative haemolysis secondary to sepsis, rapid growth with concomitant protein and iron deficiency, bleeding diathesis etc., can also contribute to anaemia in preterm infants.Assessing the risk factors and clinical conditions before the first transfusion will improve the ability to estimate the need for RBC transfusions of low birth weight (LBW) infants.