Premature infants with the AB blood type who develop necrotizing enterocolitis are nearly 3 times more likely to die from it as preemies with other blood types, according to a recent study. A straightforward change in blood transfusion practice can reduce mortality, however. What do the researchers recommend?
Mortality from necrotizing enterocolitis (NEC) approaches 25% but could be reduced by a fairly straightforward change in practice: transfusing premature infants with their specific blood types instead of the universal donor type O.
That’s according to a study from Loyola University, which found that premature infants with the AB blood type who develop NEC are nearly 3 times more likely to die from it as preemies with other blood types.
NEC, the most common serious gastrointestinal disorder among preterm newborns, affects about 7,000 infants a year. While most cases of NEC are mild to moderate and treated with antibiotics, severe cases can perforate the intestine and result in a life-threating infection. Researchers noted that several factors are involved in NEC, including a decrease in blood flow to the bowel, infection, mechanical injury, and abnormal immune response.
Changing what type blood is transfused could mediate some of those immune system issues. "Although this will likely not eradicate NEC, it is an easily modifiable factor that may help to prevent those cases of NEC that develop in relation to the transfusion of blood products," wrote senior researcher Jonathan Muraskas, MD, co-medical director of Loyola's neonatal ICU, and colleagues.
The investigators examined records of 276 preemies in Loyola's neonatal ICU with Bell stage II-III NEC during the last 24 years, looking at data on birth date, gestational age, maternal/neonatal blood group, number of transfusions, and survival time. Premature infants with AB blood types were 2.87 times more likely to die from NEC than babies with other blood types, they found.
Watoto wachanga wenye aina ya damu ya AB ambao huambukizwa enterocolitis ya necrotizing wana uwezekano mkubwa wa kufa kutokana na ugonjwa huo kama watoto wachanga wenye aina nyingine za damu, kulingana na utafiti wa hivi karibuni. Hata hivyo, badiliko la moja kwa moja katika mazoea ya kutiwa damu mishipani laweza kupunguza vifo. Watafiti wanapendekeza nini? Ugonjwa wa necrotizing enterocolitis (NEC) unaathiri watoto wachanga ambao wamezaliwa kabla ya wakati wao, na kwa hivyo ni hatari zaidi kwa watoto wachanga ambao wana aina ya damu ya AB. Ugonjwa wa NEC ni ugonjwa wa kawaida wa tumbo la uzazi kwa watoto wachanga waliozaliwa kabla ya wakati, na huathiri watoto wapatao 7,000 kwa mwaka. Ingawa visa vingi vya NEC ni vya kiwango cha chini hadi cha wastani na hupatiwa dawa za kuua viini, visa vikali vinaweza kupenya matumbo na kusababisha maambukizi ya hatari ya maisha. Watafiti wanasema kuna mambo kadhaa yanayohusika katika ugonjwa huo, ikiwa ni pamoja na kupungua kwa mtiririko wa damu kwenye matumbo, maambukizo, majeraha ya kiufundi, na majibu ya kinga yasiyo ya kawaida. Kubadilisha aina ya damu inayopatiwa inaweza kusuluhisha baadhi ya matatizo hayo ya mfumo wa kinga. "Hata hivyo, kwa sababu ya hali hii, ni rahisi kuepuka NEC, ""aliandika Jonathan Murashka, MD, mkurugenzi wa matibabu wa Neonatal ICU ya Loyola." Watafiti walichunguza rekodi za watoto 276 waliozaliwa kabla ya wakati katika kitengo cha wagonjwa wa Loyola na NEC ya hatua ya Bell II-III katika miaka 24 iliyopita, wakitazama data juu ya tarehe ya kuzaliwa, umri wa ujauzito, kundi la damu la mama na mtoto mchanga, idadi ya uingizaji damu, na muda wa kuishi. Watoto waliozaliwa kabla ya wakati na aina ya damu ya AB walikuwa na uwezekano wa mara 2.87 zaidi ya kufa kutokana na NEC kuliko watoto wenye aina nyingine za damu.