Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Crawley, WA, Australia.
Department of Neonatology, Princess Margaret Hospital for Children, Perth, WA, Australia.
Acta Paediatr. 2018 May;107(5):759-766. doi: 10.1111/apa.14187. Epub 2018 Jan 11.
This study evaluated the correlation between retinopathy of prematurity (ROP), anaemia and blood transfusions in extremely preterm infants.
We included 227 infants born below 28 weeks of gestation at King Edward Memorial Hospital, Perth, Australia, from 2014-2016. Birth characteristics and risk factors for ROP were retrieved, and anaemia and severe anaemia were defined as a haemoglobins of <110 g/L and <80 g/L, respectively. Logistic regression was used for the analysis.
Retinopathy of prematurity treatment was needed in 11% of cases and the mean number of blood transfusions (p < 0.01), and mean number of weeks of anaemia (p < 0.001) and of severe anaemia (p < 0.05), had positive associations with ROP cases warranting treatment. In the multivariate logistic regression analysis, the best-fit model of risk factors included anaemic days during first week of life, with an odds ratio (OR) of 1.46% and 95% confidence interval (CI) of 1.16-1.83 (p < 0.05), sepsis during the first 4 weeks of life (OR 3.14, 95% CI 1.10-9.00, p < 0.05) and days of ventilation (OR 1.03, 95% CI 1.01-1.06, p < 0.05).
The duration of anaemia during the first week of life was an independent risk factor for ROP warranting treatment and preventing early anaemia may decrease this risk.
本研究评估了早产儿视网膜病变(ROP)、贫血和输血之间的相关性极低出生体重儿。
我们纳入了 2014 年至 2016 年期间在澳大利亚珀斯爱德华国王纪念医院出生且胎龄小于 28 周的 227 名婴儿。我们检索了与 ROP 相关的出生特征和危险因素,并将贫血和严重贫血定义为血红蛋白分别<110 g/L 和<80 g/L。采用 Logistic 回归进行分析。
11%的患儿需要接受 ROP 治疗,且输血次数(p<0.01)、贫血周数(p<0.001)和严重贫血周数(p<0.05)均与需要治疗的 ROP 病例呈正相关。在多变量 Logistic 回归分析中,风险因素的最佳拟合模型包括生命最初一周内的贫血天数,比值比(OR)为 1.46%,95%置信区间(CI)为 1.16-1.83(p<0.05),前 4 周内的败血症(OR 3.14,95%CI 1.10-9.00,p<0.05)和通气天数(OR 1.03,95%CI 1.01-1.06,p<0.05)。
生命最初一周内的贫血持续时间是 ROP 治疗的独立危险因素,预防早期贫血可能会降低这种风险。