Effects of peripheral and umbilical cord blood sampling on transfusion and complications in very low birth weight infants during hospitalization / 中华围产医学杂志

ABSTRACT

Objective:To analyze the effects of different blood sampling methods on the incidence of iatrogenic blood loss, anemia, transfusion, and complications in very low birth weight infants (VLBWI) during hospitalization.Method:A retrospective analysis was performed on VLBWIs (birth weight <1 500 g) admitted to the neonatal intensive care unit of the Second Hospital of Yangtze University, Jingzhou Central Hospital, Hubei province, from January 2014 to December 2018. According to the first blood sampling method, these infants were subjected to the umbilical cord blood and peripheral blood groups. Blood sampling, transfusion, complications, and outcomes were compared between the two groups. Independent samples t-test, rank-sum test, and Chi-square (or Fisher's exact) test were used for statistical analysis. Results:(1) Totally 240 neonates enrolled, including 104 cases in the umbilical cord blood group and 136 in the peripheral blood group. There was no statistical significance in the general information and blood test results for the first time between the two groups. (2)The blood volume collected in the first week in the umbilical cord blood group was lower than that in the peripheral blood group [6.5 ml (1-23 ml) and 10 ml (1-30 ml), Z=－4.706, P<0.01]. Differences between the two groups in the blood volume at 2-9 weeks were insignificant (all P>0.05). The number of blood collection procedures in each of the first four weeks after birth in the umbilical cord blood group was less than that in the peripheral blood group ( Z value was－9.124,－2.272,－4.688, and－2.017, respectively, all P<0.05), but no statistical difference was found at the fifth week ( P>0.05). The time of the first red blood cell transfusion (RBCT) in the umbilical cord blood group was later than that in the peripheral blood group [4 weeks (1-7 weeks) vs 3 weeks (1-5 weeks), Z=－2.839, P<0.05]. The proportion of infants who have received RBCT twice or more times in the umbilical cord blood group was lower than that in the peripheral blood group [39.7% (25/63) vs 56.8% (50/88), χ2=4.312, P<0.05]. The rate of RBCT during the first three weeks in the umbilical cord blood group was lower than that in the peripheral blood group [34.9% (22/63) vs 59.1% (52/88), χ2=8.583, P<0.05]. There were no significant differences in the volume of RBCT per time, adverse reactions after transfusion, and the erythrocyte count, hemoglobin, and hematocrit before and after the first RBCT between the two groups. (3) The incidence of neonatal respiratory distress syndrome, neonatal necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage (grade Ⅲ-Ⅳ) and their outcomes were similar between the two groups (all P>0.05). Conclusion:Blood sampling methods show no significant effect on the total incidence of anemia and RBCT in VLBWIs during hospitalization. Umbilical cord blood sampling may delay the first RBCT time of VLBWIs and reduce the rate of RBCT in the first three weeks, but do not affect the incidence of complications.