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Mortality from necrotizing enterocolitis reduced by change in transfusion practices


Premature infants with the AB blood type who develop necrotizing enterocolitis are nearly 3 times more likely to die from it as preemies with other blood types, according to a recent study. A straightforward change in blood transfusion practice can reduce mortality, however. What do the researchers recommend?

Mortality from necrotizing enterocolitis (NEC) approaches 25% but could be reduced by a fairly straightforward change in practice: transfusing premature infants with their specific blood types instead of the universal donor type O.

That’s according to a study from Loyola University, which found that premature infants with the AB blood type who develop NEC are nearly 3 times more likely to die from it as preemies with other blood types.

NEC, the most common serious gastrointestinal disorder among preterm newborns, affects about 7,000 infants a year. While most cases of NEC are mild to moderate and treated with antibiotics, severe cases can perforate the intestine and result in a life-threating infection. Researchers noted that several factors are involved in NEC, including a decrease in blood flow to the bowel, infection, mechanical injury, and abnormal immune response.

Changing what type blood is transfused could mediate some of those immune system issues. "Although this will likely not eradicate NEC, it is an easily modifiable factor that may help to prevent those cases of NEC that develop in relation to the transfusion of blood products," wrote senior researcher Jonathan Muraskas, MD, co-medical director of Loyola's neonatal ICU, and colleagues.

The investigators examined records of 276 preemies in Loyola's neonatal ICU with Bell stage II-III NEC during the last 24 years, looking at data on birth date, gestational age, maternal/neonatal blood group, number of transfusions, and survival time. Premature infants with AB blood types were 2.87 times more likely to die from NEC than babies with other blood types, they found.

Go back to the current issue of the eConsult.

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