Elsevier

The Journal of Pediatrics

Volume 201, October 2018, Pages 215-220
The Journal of Pediatrics

Original Articles
Impact of Blood Donor Sex on Transfusion-Related Outcomes in Preterm Infants

https://doi.org/10.1016/j.jpeds.2018.04.023Get rights and content

Objective

Explore the role of red blood cell donor sex on preterm infant neonatal outcomes.

Study design

In a retrospective, exploratory, cohort study, the hospital blood bank database was queried for units of blood released to neonatal intensive care unit patients in 2009-2010. The state blood center provided donor sex, and a department database provided neonatal characteristics and morbidities. Comparisons were made for 2 groups: those who ever received female blood and those who did not.

Results

Among 462 infants <32 weeks of gestation, 190 (41%) received >1 blood transfusion. In univariate analyses, compared with infants who received only male blood, infants who received female donor blood had higher rates of bronchopulmonary dysplasia (38% vs 22%; P = .03), spontaneous intestinal perforation/necrotizing enterocolitis (17% vs 6%; P = .04), and death or any morbidity (60% vs 38%; P < .01), respectively. In adjusted analyses, female blood was associated with any morbidity (P = .0251) and 21 days longer hospitalization (P = .0098). After adding total number transfusions to the model, only an increased number of transfusions was associated with bronchopulmonary dysplasia (P = .0009), any morbidity (P = .0001), and length of stay (P = .0001). In subset regressions comparing exclusively female donor blood with male donor blood, there was a significant interaction of female donor blood and number of transfusions for any morbidity (OR 2.6 95% CI 1.2-5.7, P = .01).

Conclusions

Preliminary findings suggest that female donor blood was associated with preterm vulnerability to neonatal morbidities.

Section snippets

Methods

The Institutional Review Board at Women and Infants Hospital reviewed this exploratory, cohort study and granted a waiver of consent for the retrospective review of medical records. The study was conducted at an academic, freestanding, specialty hospital with >8000 deliveries per year and a level IV NICU with >1200 admissions annually.

All NICU patients who received blood product transfusions (packed red blood cells, platelets, or plasma) were identified in the following manner: the hospital

Results

In total, 2418 patients were admitted to the NICU with date of birth January 1, 2009-December 31, 2010. During that time period, 1026 blood transfusions were administered to 248 patients (mean 4.1; range 1-41). Compared with term infants, infants born at 32-336/7 weeks of gestation and 34-366/7 weeks of gestation were not more likely to be transfused OR 0.64; CI = 0.34-1.19 and 1.01; CI = 0.51-1.99, respectively. However, the odds of being transfused if born at <32 weeks of gestation was

Discussion

In this exploratory, retrospective, cohort study, we demonstrate an association between the transfusion of female blood and increased rates of BPD and SIP/NEC in preterm infants born at <32 weeks of gestation. We additionally report an association between transfusion of female blood and a higher composite rate of death or major neonatal morbidities. These findings appear consistent with adult studies linking transfusion of female donor plasma to higher incidence of transfusion- associated lung

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  • Cited by (18)

    • Neonatal Blood Banking Practices

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    • Sex specificity in neonatal diseases

      2023, Principles of Gender-Specific Medicine: Sex and Gender-Specific Biology in the Postgenomic Era
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    The authors declare no conflicts of interest.

    Portions of this study were presented at the Pediatric Academic Societies annual meeting, April 25-28, 2015, San Diego, California.

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