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

被引:40
作者
Patel, Ravi Mangal [1 ,2 ]
Knezevic, Andrea [3 ,4 ]
Yang, Jing [3 ,5 ]
Shenvi, Neeta [3 ]
Hinkes, Michael [6 ]
Roback, John D. [7 ]
Easley, Kirk A. [3 ]
Josephson, Cassandra D. [2 ,7 ,8 ]
机构
[1] Emory Univ, Sch Med, Dept Pediat, Div Neonatol, Atlanta, GA USA
[2] Childrens Healthcare Atlanta, Atlanta, GA USA
[3] Rollins Sch Publ Hlth, Biostat & Bioinformat, Atlanta, GA USA
[4] Mem Sloan Kettering Canc Ctr, Epidemiol & Biostat, New York, NY USA
[5] Merck & Co Inc, Biostat & Res Decis Sci, Kenilworth, NJ USA
[6] Northside Hosp, Atlanta, GA USA
[7] Emory Univ, Sch Med, Pathol & Lab Med, Ctr Transfus & Cellular Therapies, Atlanta, GA USA
[8] Emory Univ, Div Hematol & Oncol, Aflac Canc & Blood Disorders Ctr, Sch Med, Atlanta, GA USA
基金
美国国家卫生研究院;
关键词
CHRONIC LUNG-DISEASE; OXIDATIVE STRESS; DEFINITION; ANEMIA; OXYGEN;
D O I
10.1111/trf.15216
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND Enteral iron supplementation and RBC transfusions are routinely administered to very-low-birth-weight (VLBW) infants, although the potential risks of these exposures have not been adequately quantified. This study evaluated the association between the cumulative dose of enteral iron supplementation, total volume of RBCs transfused, and risk of bronchopulmonary dysplasia (BPD) in VLBW infants. STUDY DESIGN AND METHODS Retrospective, multicenter observational cohort study in Atlanta, Georgia. Cumulative supplemental enteral iron exposure and total volume of RBCs transfused were measured until the age at assessment of BPD. Multivariable generalized linear models were used to control for confounding, and the reliability of the factors was assessed in 1000 bootstrap models. RESULTS A total of 598 VLBW infants were studied. In multivariable analyses, a greater cumulative dose of supplemental enteral iron exposure was associated with an increased risk of BPD (adjusted relative risk per 50-mg increase, 1.07; 95% confidence interval [CI], 1.02-1.11; p = 0.002). Similarly, a greater volume of RBCs transfused was associated with a higher risk of BPD (adjusted relative risk per 20-mL increase, 1.05; 95% CI, 1.02-1.07; p < 0.001). Both factors were reliably associated with BPD (>50%). Volume of RBCs transfused was similar to gestational age in reliability as a risk factor for BPD (present in 100% of models) and was more reliable than mechanical ventilation at 1 week of age. CONCLUSION The cumulative dose of supplemental enteral iron exposure and total volume of RBC transfusion are both independently associated with an increased risk of BPD in VLBW infants.
引用
收藏
页码:1675 / 1682
页数:8
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