The Effect of Haemoglobin and Blood Transfusion on Preterm Infant Gut Perfusion and Injury

Abstract

There is significant uncertainty regarding the role of anaemia or blood transfusion in the development of necrotising enterocolitis in preterm infants. We conducted a prospective observational study of 48 preterm infants born at <30 weeks gestation in whom, gut perfusion and injury were assessed weekly by: 60 minutes Near Infrared Spectroscopy (NIRS) measurements (sTOI/sFTOE); stool calprotectin; urine intestinal and liver FABP; and TFF-3 until either 36 weeks post conceptional age or discharge. Exclusion criteria included Fetal Growth Restriction (FGR), and abnormal antenatal Dopplers. Haemoglobin levels were measured in parallel with NIRS measurements. NIRS and the urine and stool biomarkers of gut injury were evaluated up to 72 hours before/after transfusion and pre/post measurements compared. Our results demonstrated no significant association of Haemoglobin with either sTOI/sFTOE or any gut biomarker level. There was no significant difference in pre and post RBCT NIRS measurements or gut biomarker levels. We showed no association of anaemia or transfusion with gut injury in preterm infants. Further studies with standardised methods of examining the relationship between anaemia, transfusion, and gut injury are needed in FGR infants.