Incidence & Risk Factors for The Development of Transfusion-Associated Necrotizing Enterocolitis in Preterm Infants After Packed red Blood Cells Transfusion. A Prospective-Observational Study

Background: Necrotizing enterocolitis (NEC) is a progressing inflammatory disease that is associated with high rates of morbidity and mortality in preterm babies. Transfusion-associated necrotizing enterocolitis (TANEC) is described as NEC where symptoms &/or signs start within 48 hours of blood or packed red blood cells (PRBCs) transfusion.Objective: To determine the incidence of TANEC in preterms admitted to our neonatal intensive care unit & to identify the possible risk factors.Methods: sixty (60) preterms were conducted in this prospective observational study, they received packed red blood cells (PRBCs) transfusion due to different indications admitted to the NICU of the department of Pediatrics, Cairo University hospitals for a 6-months-duration and monitoring group of preterms who developed TANEC and compare all the possible risk factors.Results: Out of the 60 preterms enrolled in the study, 13 (21.7%) preterms developed NEC within 48 hours after PRBCs transfusion. According to modified Bell´s staging for NEC: 7 preterms were diagnosed as stage I , 2 preterms were diagnosed as stage IIA, and 4 preterms in stage IIB, none of them required any surgical interventions, and no mortalities were detected among them. Low Apgar scores at 5 and 10 minutes & gestational age and low birth weight were highly statistically significant variants between both groups.Conclusion: Keeping preterms receiving nothing per oral before, during & after PRBCs transfusion showed statistically significant protection against TANEC. The most significant alarming sign was the occurrence of episodes of apnea 12 hours after transfusion with a highly significant value