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Am J Perinatol. 2019 Apr 4. doi: 10.1055/s-0039-1683982. [Epub ahead of print]

Severe Anemia Is Associated with Intestinal Injury in Preterm Neonates.

Author information

1
Department of Neonatology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey.
2
Faculty of Medicine, Department of Neonatology, Eskişehir Osmangazi University, Eskisehir, Turkey.
3
Department of Neonatalogy, Yildirim Beyazit Universty Faculty of Medicine, Ankara, Turkey.

Abstract

BACKGROUND:

 A temporal relationship has been reported between necrotizing enterocolitis, anemia, and red blood cell transfusion (RBCT) in preterm neonates. However, the mechanism underlying this association is not clearly defined. Intestinal (I-) and liver (L-) fatty acid binding proteins (FABPs) have been proposed as plasma markers for the detection of acute intestinal injury.

AIM:

 To investigate the effect of anemia and RBCT on intestinal injury in preterm neonates by measuring serum I-FABP and L-FABP levels.

METHODS:

 A prospective cohort study including preterm neonates with gestational age <32 weeks and/or birth weight <1,500 g and requiring erythrocyte transfusions for anemia after day 15 of life was conducted. Stable growing preterm infants with hemoglobin values ≥ 10 g/dL were taken as controls. I-FABP and L-FABP levels of the neonates with anemia were compared with levels of the control group. In addition, pretransfusion I-FABP and L-FABP levels of the neonates with anemia were compared with posttransfusion levels.

RESULTS:

 In total, 39 infants transfused for anemia and 20 controls were enrolled. L-FABP levels were significantly higher in neonates with anemia compared with controls (p < 0.001), whereas I-FABP (p = 0.695) was not different. L-FABP and I-FABP levels were similar before and after transfusion in neonates with anemia. L-FABP levels before transfusion were negatively correlated with pretransfusion hemoglobin levels (p < 0.001).

CONCLUSION:

 Anemia is associated with intestinal injury documented by increased L-FABP levels in preterm infants, and this injury is more severe with lower hemoglobin levels.

PMID:
30947347
DOI:
10.1055/s-0039-1683982

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