Study: Preterm babies don’t benefit from higher red blood cell transfusions – UPI News

Preterm babies may not benefit from high-hemoglobin blood transfusions, a new study has found. File Photo by Praisaeng/Shutterstock

Dec. 30 (UPI) -- Very low birth weight babies born with anemia don't need transfusions with a high number of red blood cells to avoid complications such as developmental delays, cerebral palsy, or hearing and vision loss, a study published Wednesday by the New England Journal of Medicine found.

About 50% of preterm infants given high-red-blood-cell transfusions died or suffered a complication, roughly the same percentage as those who received transfusions with lower red-blood-cell counts, the data showed.

This suggests that transfusions given to preterm infants don't necessarily need to have higher red blood cell counts, the researchers said.

Such transfusions carry a higher risk for side effects and other complications, including infections such as sepsis, they said.

"Our study shows that a commonplace therapy considered to be standard practice may not have received adequate ... proof for benefit or harm," study co-author Dr. Haresh Kirpalani told UPI.

"There needs to be more such systematic evaluation, [but] we still need to follow these babies to age 5 years to ensure nothing different is found in the even longer term," said Kirpalani, emeritus professor of pediatrics at the University of Pennsylvania.

Very preterm infants -- those born before 29 weeks of pregnancy -- and those weighing less than 2 pounds are at high risk for anemia because of their early stage of development.

This includes a reduced ability to produce red blood cells and a need for increased blood sampling as part of their intensive medical care, according to Kirpalani and his colleagues.

Earlier research has suggested anemic infants would have a lower risk of death, developmental delays, cerebral palsy and hearing and vision loss if they received transfusions with higher levels of red blood cells, the researchers said.

Generally, transfusion thresholds for preterm infants vary based on weight, stage of maturity and other factors. Measuring hemoglobin, a protein produced in red blood cells, indicates the proportion of red blood cells in the transfusion, they said.

For their National Institutes of Health-funded study, Kirpalani and his colleagues assessed health outcomes in 845 infants who received transfusions with higher hemoglobin thresholds and compared them to those among 847 infants who received lower-hemoglobin transfusions.

Of those who received higher levels of red blood cells, 50.1% died or survived with a neuro-developmental impairment, the data showed.

Among those given transfusions with lower levels, 49.8% died or survived with a neuro-developmental impairment, the researchers said.

Based on their findings, the researchers concluded that higher hemoglobin thresholds increased the number of transfusions, but did not improve the chance of survival without neuro-developmental impairment in preterm infants.

"For most very small and immature babies, there is no benefit in the short term or longer term to ... keeping hemoglobin at the higher range we studied," Kirpalani said.

"There should be fewer blood transfusions, which would mean fewer need for intravenous sites, likely fewer pricks and pains to the baby and possibly even lower the rates of infections [and] it might also reserve blood for the most needed situations," he said.

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Study: Preterm babies don't benefit from higher red blood cell transfusions - UPI News