Haemoglobin level at birth is associated with short term outcomes and mortality in preterm infants
Author(s)
Type
Journal Article
Abstract
Background Blood volume and haemoglobin (Hb) levels are increased by delayed umbilical cord clamping, which has been reported to improve clinical outcomes of preterm infants. The objective was to determine whether Hb level at birth was associated with short term outcomes in preterm infants born at ≤32 weeks gestation. Methods Data were collected retrospectively from electronic records: Standardised Electronic Neonatal Database, Electronic Patient Record, Pathology (WinPath), and Blood Bank Electronic Database. The study was conducted in a tertiary perinatal centre with around 5,500 deliveries and a neonatal unit admission of 750 infants per year. All inborn preterm infants of 23 to 32 weeks gestational age (GA) admitted to the neonatal unit from January 2006 to September 2012 were included. The primary outcomes were intra-ventricular haemorrhage, necrotising entero-colitis, broncho-pulmonary dysplasia, retinopathy of prematurity, and death before discharge. The secondary outcomes were receiving blood transfusion and length of intensive care and neonatal unit days. The association between Hb level (g/dL) at birth and outcomes was analysed by multiple logistic regression adjusting for GA and birth weight (BWt). Results Overall, 920 infants were eligible; 28 were excluded because of missing data and 2 for lethal congenital malformation. The mean (SD) GA was 28.3 (2.7) weeks, BWt was 1,140 (414) g, and Hb level at birth was 15.8 (2.6) g/dL. Hb level at birth was significantly associated with all primary outcomes studied (P <0.001) in univariate analyses. Once GA and BWt were adjusted for, only death before discharge remained statistically significant; the OR of death for infants with Hb level at birth <12 g/dL compared with those with Hb level at birth of ≥18 g/dL was 4.1 (95% CI, 1.4–11.6). Hb level at birth was also significantly associated with blood transfusion received (P <0.01) but not with duration of intensive care or neonatal unit days. Conclusions Low Hb level at birth was significantly associated with mortality and receiving blood transfusion in preterm infants born at ≤32 weeks gestation. Further studies are needed to determine the association between Hb level at birth and long-term neurodevelopmental outcomes.
Date Issued
2015-01-27
Online Publication Date
2021-01-05T10:57:14Z
Date Acceptance
2014-12-08
ISSN
1741-7015
Publisher
BioMed Central
Start Page
1
End Page
7
Journal / Book Title
BMC Medicine
Volume
13
Copyright Statement
© 2015 Banerjee et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated.
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated.
License URI
Identifier
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0247-6
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000348401400001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Haemoglobin
Mortality
Outcome
Preterm
NEONATAL INTENSIVE-CARE
CLINICAL RISK INDEX
PREMATURE-INFANTS
CONTROLLED-TRIAL
WEIGHT INFANTS
INTRAVENTRICULAR HEMORRHAGE
BRONCHOPULMONARY DYSPLASIA
BABIES SCORE
TRANSFUSION
CHORIOAMNIONITIS
Analysis of Variance
Birth Weight
Blood Transfusion
Electronic Health Records
Female
Hemoglobins
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
Logistic Models
Male
Perinatal Mortality
Retrospective Studies
Humans
Infant, Premature, Diseases
Birth Weight
Hemoglobins
Blood Transfusion
Analysis of Variance
Logistic Models
Retrospective Studies
Infant
Infant, Newborn
Infant, Premature
Female
Male
Perinatal Mortality
Electronic Health Records
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Haemoglobin
Mortality
Outcome
Preterm
NEONATAL INTENSIVE-CARE
CLINICAL RISK INDEX
PREMATURE-INFANTS
CONTROLLED-TRIAL
WEIGHT INFANTS
INTRAVENTRICULAR HEMORRHAGE
BRONCHOPULMONARY DYSPLASIA
BABIES SCORE
TRANSFUSION
CHORIOAMNIONITIS
11 Medical and Health Sciences
General & Internal Medicine
Publication Status
Published
Article Number
ARTN 16
Date Publish Online
2015-01-27