Effects of anemia and red blood cell transfusion in preterm infants on the development of bronchopulmonary dysplasia: a propensity score analysis

Abstract

To determine association of severe anemia and red blood cell (RBC) transfusions with bronchopulmonary dysplasia (BPD) in preterm infants with gestational age <32 weeks, a retrospective analysis was conducted on 364 newborns from August 1,2018, until August 31,2020. 135 patients were diagnosed with BPD and the other 229 neonates were included in the non-BPD group. One-to-one propensity score matching (83:83) was used to match the baseline characteristics and confounding factors of patients so as to better evaluate effects of anemia and RBC transfusion. The results showed that the rate of severe anemia was significantly different between the BPD group and non-BPD group [14/83(16.87) vs 4/83(4.82), p = 0.013]. The number and volume of transfusion were significantly lower in the non-BPD group than in the BPD group [number:1(0,2) vs 2(0,4), p = 0.001;volume:30(0,40) vs 40(20,80), p = 0.004]. We find that Among anemic neonates,only severe anemia may increase the risk of developing BPD. Larger volume and higher number of RBC transfusions are related to BPD and its severity. Risk of BPD was neither related to the onset of anemia nor the timing of first transfusion. Medical methods should be adopted to prevent severe anemia and reduce RBC transfusions. Registration Name of registry: Chinese Clinical Trial Registry, Registry number: ChiCTR 2100042768. Registration date: 28 January, 2021. URL of the trial in the registry database:http://www.chictr.org.cn/listbycreater.aspx.