Sharma R, Kraemer D F, Torrazza R M, Mai V, Neu J, Shuster J J, Hudak M L
Department of Pediatrics, University of Florida College of Medicine, Jacksonville, FL, USA.
Center for Health Equity and Quality Research, Department of Neurology, University of Florida College of Medicine, Jacksonville, FL, USA.
J Perinatol. 2014 Nov;34(11):858-62. doi: 10.1038/jp.2014.59. Epub 2014 Aug 21.
Recent reports have posited a temporal association between blood transfusion with packed red blood cells (BT) and necrotizing enterocolitis (NEC). We evaluated the relationship between BT and NEC among infants at three hospitals who were consented at birth into a prospective observational study of NEC.
We used a case-control design to match each case of NEC in our study population of infants born at<33 weeks postmenstrual age (PMA) to one control infant using hospital of birth, PMA, birth weight and date of birth.
The number of transfusions per infant did not differ between 42 NEC cases and their controls (4.0 ± 4.6 vs 5.4 ± 4.1, mean ± s.d., P = 0.063). A matched-pair analysis did not identify an association of transfusion with NEC in either the 48-h or 7-day time periods before the onset of NEC. Stratifying on matched-sets, the Cox proportional hazard model did not identify any difference in the total number of BTs between the two groups (hazard ratio 0.78, 95% confidence interval 0.57 to 1.07, P = 0.11).
In contrast to previous studies, our case-control study did not identify a significant temporal association between BT and NEC. Additional large prospective randomized studies are needed to clarify the relationship between BT and NEC.
近期报告提出输注浓缩红细胞（BT）与坏死性小肠结肠炎（NEC）之间存在时间关联。我们评估了三家医院中出生时同意参与NEC前瞻性观察研究的婴儿中BT与NEC之间的关系。
我们采用病例对照设计，将研究人群中胎龄<33周出生的NEC患儿与一名对照婴儿进行匹配，匹配因素包括出生医院、胎龄、出生体重和出生日期。
42例NEC患儿与其对照婴儿的人均输血次数无差异（4.0±4.6对5.4±4.1，均值±标准差，P = 0.063）。配对分析未发现NEC发病前48小时或7天内输血与NEC有关联。在匹配组分层分析中，Cox比例风险模型未发现两组间BT总数有任何差异（风险比0.78，95%置信区间0.57至1.07，P = 0.11）。
与先前研究不同，我们的病例对照研究未发现BT与NEC之间存在显著的时间关联。需要更多大型前瞻性随机研究来阐明BT与NEC之间的关系。
