932 A Retrospective Study of Packed Red Blood Cell Transfusion in Necrotising Enterocolitis

Abstract

Aims:We evaluated the role of packed red blood cell (PRBC) transfusion on the causation of necrotising enterocolitis (NEC) in neonates. Methods:In a retrospective observational study (April 08-March 09), we compared neonates who developed NEC after PRBC transfusion (transfusion group) to neonates who developed NEC without blood transfusion (controls). Results:Over the one year period, 20 neonates developed NEC (2/1000 live births). Gestation less than 30 weeks(75%) and birth weight less than 1500 grams (93.3%) were the most common risk factors. Nine (55.6%) babies had received a recent PRBC transfusion. The gestational age of the transfusion group (27.5 weeks) was comparable to the control group (26.89 weeks). NEC developed at a mean post natal age of 42 days in the transfusion group against 19.2 days in controls. 50% of babies in the transfusion group were Black African ethnicity compared to 14.3% in the control group. Perforating NEC developed in 22.2% of babies in the transfusion group (42.8% in the control group). An abnormal antenatal ultrasound scan (23.1%), maternal smoking (25%), antepartum haemorrhage (21.4%), chorioamnionitis (33.3%) and emergency caesarean section delivery (40%) were moderately associated with NEC, but were not significantly different between the groups. There was a bimodal pattern of onset. Early symptoms developed within 72 hours (mean 2.6 days) of the packed red cell transfusion in five (55.6%) babies and late symptoms developed at mean 10.6 days. Conclusions:There is a close association between blood transfusion and NEC. Black African babies and older babies are at increased risk.