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Exchange transfusion safety and outcomes in neonatal hyperbilirubinemia.
Journal of Perinatology ( IF 2.4 ) Pub Date : 2020-03-09 , DOI: 10.1038/s41372-020-0642-0
Mattie F Wolf 1 , Julie Childers 1 , Keyaria D Gray 1 , Caroline Chivily 2 , Mike Glenn 2 , Laila Jones 2 , Mini Kpa 2 , Taylor McMannen 2 , Isaias Reyes 2 , Kanecia O Zimmerman 1, 2 , Reese H Clark 3 , Rachel G Greenberg 1, 2
Affiliation  

Objective

To characterize the prevalence of exchange transfusion (ET), clinical characteristics of infants receiving ET, and ET-associated morbidity and mortality.

Study design

We conducted a multicenter cohort study of infants ≥23 weeks of gestational age (GA) with hyperbilirubinemia who underwent ET within 30 days of birth from 1997 to 2016. We examined clinical characteristics and adverse events after ET. We used multivariable logistic regression to examine the association between clinical risk factors and death.

Result

A total of 1252 infants were included; 4% died within 7 days of ET and 6% died before discharge. Compared with infants ≥37 weeks of GA, infants ≤29 weeks of GA had greater odds of death (adjusted odds ratio [95% confidence interval] = 20.08 [7.32, 55.07]).

Conclusions

Infants ≤ 29 weeks of GA had greater odds of death following ET compared with term infants. These data will support clinicians in evaluating risks and prognosis for infants who require ET.



中文翻译:


新生儿高胆红素血症的换血安全性和结果。


 客观的


旨在描述换血 (ET) 的流行率、接受 ET 的婴儿的临床特征以及 ET 相关的发病率和死亡率。

 研究设计


我们对1997年至2016年出生后30天内接受ET的≥23周胎龄(GA)患有高胆红素血症的婴儿进行了一项多中心队列研究。我们检查了ET后的临床特征和不良事件。我们使用多变量逻辑回归来检查临床危险因素与死亡之间的关联。

 结果


总共包括 1252 名婴儿; 4% 在 ET 后 7 天内死亡,6% 在出院前死亡。与 GA ≥ 37 周的婴儿相比,GA ≤ 29 周的婴儿死亡几率更高(调整后的比值比 [95% 置信区间] = 20.08 [7.32, 55.07])。

 结论


与足月婴儿相比,GA ≤ 29 周的婴儿在 ET 后死亡的几率更高。这些数据将支持临床医生评估需要 ET 的婴儿的风险和预后。

更新日期:2020-04-24
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