Association between anemia and bronchopulmonary dysplasia in preterm infants

Abstract

Anemia is commonly seen in preterm infants. It may reduce the capacity of hemoglobin to transport oxygen throughout the body and may result in tissue and organ dysfunction. This study aimed to investigate the effect of anemia on the development of bronchopulmonary dysplasia (BPD) in preterm infants. 243 infants who were admitted to BaYi Children’s Hospital Affiliated to Clinical Medical College in Beijing Military General Hospital with gestational age (GA) less than 32 weeks from February, 2014 to February, 2015 were included in the study. Maternal and infant data were recorded. Multivarariate logistic regression analysis was performed to determine the association between anemia and BPD. Of 243 preterm infants, the incidence of anemia was higher in BPD patients than non-BPD patients (p < 0.001). Mean Hct in BPD patients was lower than non-BPD patients at different time points in 1d, 7d, 14d, and 21d. Controlling for other confounding factors, early anemia was associated with an increased risk of BPD. Number of transfusions is also a significant risk factor for BPD (p = 0.001). Therefore, prevention and treatment of early anemia is necessary and reducing number of transfusions may reduce the incidence of BPD in preterm infants.

Enteral iron supplementation, red blood cell transfusion, and risk of bronchopulmonary dysplasia in very‐low‐birth‐weight infants

“…We found an association between a greater total volume of RBCs transfused and higher risk of BPD. This finding has been previously reported in prior observational studies, including a prospective observational study in the United Kingdom and more recent single‐center observational studies from China . A study from Korea found similar associations between volume and number of RBC transfusions and BPD in a univariable analysis, but no association with ferritin levels or average iron supplementation during hospitalization and BPD .…”

“…This finding has been previously reported in prior observational studies, including a prospective observational study in the United Kingdom 24 and more recent single-center observational studies from China. 7,25 A study from Korea found similar associations between volume and number of RBC transfusions and BPD in a univariable analysis, but no association with ferritin levels or average iron supplementation during hospitalization and BPD. 26 By contrast, a recent prospective study from Japan found hyperferritinemia (ferritin ≥500 ng/mL) to be associated with a higher risk of BPD.…”

Neonatal clinical blood sampling led to major blood loss and was associated with bronchopulmonary dysplasia

“…Various studies have shown that BPD and other neonatal morbidities were associated with anaemia and adult blood transfusions. 21,22 It is well known that samplingrelated blood loss during neonatal clinical care is linked to the number of blood transfusions administered. 23 Extremely preterm infant blood contains components unique for foetal development, predominantly foetal haemoglobin.…”

Overexpression of AGT promotes bronchopulmonary dysplasis via the JAK/STAT signal pathway

“…For example, breastmilk feeding for the premature infants was identified to be tightly involving in a reduced risk of BPD by meta analysis on about 460 infants [ 6 ]. The early anemia was proved to be related with an increased risk of BPD by meta analysis on the 243 infants with gestational age less than 32 weeks [ 7 ]. It was found that the number of transfusions was one of the key risk factors for BPD [ 7 ], other factors such as virus infection [ 8 ], nutrition [ 9 ], genetic predisposition [ 10 ] were also identified to be associated with the BPD.…”

“…The early anemia was proved to be related with an increased risk of BPD by meta analysis on the 243 infants with gestational age less than 32 weeks [ 7 ]. It was found that the number of transfusions was one of the key risk factors for BPD [ 7 ], other factors such as virus infection [ 8 ], nutrition [ 9 ], genetic predisposition [ 10 ] were also identified to be associated with the BPD. In all, the great progresses in elucidating the mechanism of the BPD were obtained, but completely understanding to the pathogenesis of the BPD is still in trouble due to the complexity and multifactor in aetiology.…”