Medicine Department (DMed), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.
Department of Pediatrics, University of Vale do Itajaí, Itajaí, Santa Catarina, Brazil.
Vox Sang. 2024 Jan;119(1):8-15. doi: 10.1111/vox.13553. Epub 2023 Nov 3.
Red blood cell transfusions are frequent in preterm neonates. The proportion of preterm neonates transfused in Brazil remains unknown. We systematically reviewed the literature to estimate the frequency of red blood cell transfusions in preterm neonates in Brazil.
The LILACS, EMBASE, Cochrane, SciELO, MEDLINE (PubMed), Web of Science, Scopus, BDTD and 27 national university institutional databases were searched for studies that analysed red blood cell transfusion in preterm neonates in Brazil without period restriction. The Preferred Reporting Items in Systematic Reviews and Meta-Analyses guidelines were followed, and the GRADE methodology was applied. A random-effects model along with the restricted maximum likelihood method was used, and the Freeman-Tukey transformed proportion was used to estimate effect size.
Nine studies, representing 6548 preterm neonates, were included in the qualitative and quantitative analyses. The mean gestational age ranged from 26.0 to 31.6 weeks. Most of the studies were from the Southeast region. The pooled estimated frequency of red blood cell transfusions was 58.0% (95% confidence interval = 52.0%-64.0%, p < 0.001) with low certainty. There was statistically significant heterogeneity among studies (I = 92.5%, p < 0.001).
In this current meta-analysis of the evidence available, which included moderate and extremely preterm neonates, the observed frequency of red blood cell transfusions in preterm neonates in Brazil was 58.0% and this estimate can help health programming. Some Brazilian regions were not included in this study, and further research is needed to provide a more representative overview of Brazil.
红细胞输注在早产儿中较为常见。巴西早产儿接受输血的比例尚不清楚。我们系统地回顾了文献，以评估巴西早产儿接受红细胞输血的频率。
检索了 LILACS、EMBASE、Cochrane、SciELO、MEDLINE（PubMed）、Web of Science、Scopus、BDTD 和 27 个国家大学机构数据库，以查找分析巴西早产儿红细胞输血的研究，无时间限制。遵循系统评价和荟萃分析的首选报告项目，并应用 GRADE 方法。使用随机效应模型和受限最大似然法，使用 Freeman-Tukey 转换比例估计效应大小。
纳入了 9 项研究，共 6548 名早产儿，进行了定性和定量分析。平均胎龄范围为 26.0 至 31.6 周。大多数研究来自东南部地区。汇总估计的红细胞输血频率为 58.0%（95%置信区间 52.0%-64.0%，p<0.001），可信度较低。研究之间存在统计学显著的异质性（I 2 =92.5%，p<0.001）。
在这项当前对现有证据的荟萃分析中，包括中度和极早产儿，巴西早产儿接受红细胞输血的观察频率为 58.0%，这一估计值有助于制定卫生规划。本研究未包括巴西的一些地区，需要进一步研究以更全面地了解巴西。
