Abstract
Objective Bronchopulmonary dysplasia (BPD) is a leading cause of morbidity and mortality in
neonatal intensive care units. Our aim was to evaluate association between packed
red blood cell transfusion and the development of BPD in very preterm infants.
Study Design This retrospective study of very preterm infants (mean gestational age: 27.1 ± 2.4
weeks, birth weight: 970 ± 271 g) was conducted at Biruni University (Turkey) between
July 2016 and December 2020.
Results BPD developed in 107 of the 246 enrolled neonates, including 47 (43.9%), 27 (25.3%),
and 33 (30.8%) diagnosed with mild, moderate, and severe BPD, respectively. A total
of 728 transfusions were administered. The increased number (4 transfusions [2–7]
vs. 1 [1–3], p = 0.001) and volume of transfusions (75 mL/kg volume [40–130] vs. 20 [15–43], p = 0.001) were significantly higher in infants with BPD compared to those without
BPD. The transfusion volume cut-off for the prediction of BPD by receiver operating
characteristic curve analysis was 42 mL/kg (sensitivity 73.6%; specificity 75%; area
under the receiver-operating characteristic curve: 0.82). In multivariate analysis,
multiple transfusions and larger transfusion volume were independent risk factors
for moderate–severe BPD.
Conclusion The increased number and volume of transfusions were associated with BPD in very
preterm infants. A packed red blood cell transfusion volume ≥42 mL/kg was a statistically
significant predictor of the development of BPD at a postmenstrual age of 36 weeks.
Key Points
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Transfusions were found to be an important risk factor for BPD development in very
premature infants.
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Number and volume of transfusion were associated with the severity of BPD.
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Optimal cut point volume of transfusion for prediction of BPD was 42 mL/kg body weight.
Keywords
packed red blood cell transfusion - bronchopulmonary dysplasia - risk factor - very
preterm
