Alterations in Serum Lead Levels Following Packed Red Blood Cells Transfusions to Preterms Admitted to Neonatal Intensive Care Unit at Cairo University Pediatric Hospital

Abstract

Background: The study aimed to evaluate the direct effects of packed red blood cells (PRBCs) transfusions on neonatal blood lead levels (BLL) among the neonates admitted to Cairo University Pediatric Hospital (CUPH). Methods: It is a prospective cohort study including fifty-four premature neonates which took place over a period of 6 months starting from January 2018. Baseline and post-transfusion BLL were obtained. Neonatal BLL percent change was calculated to quantify the change levels before and after transfusion. Results: The neonatal BLL after transfusion was elevated one and half times more than that before transfusion. The median neonatal BLL% change was significantly higher in neonates diagnosed with extremely low birth weight and neonatal sepsis. BLL after transfusion showed a positive, moderate and significant relationship with neonatal weight, lead level in blood packs, gestational age, and blood creatinine level respectively. Multiple regression was used to explore the relationship between BLL% change and a number of predictors (e.g. neonatal age, weight, gestational age, number of transfusion times and lead level in blood packs). Conclusions: The study concluded that preterm neonates are at risk of lead exposure hazards due to receiving PRBCs transfusions. Higher lead levels in PRBCs denotes exposure of donors to higher lead levels and accordingly the recipient preterms.