Affiliation:
1. Department of Clinical Laboratory The First Affiliated Hospital of Xi’an Jiaotong University Xi'an Shaanxi China
2. Department of Transfusion Medicine Shaanxi Provincial People's Hospital Xi'an Shaanxi China
3. Department of Data Center Shaanxi Provincial People's Hospital Xi'an Shaanxi China
4. School of Public Health Xi'an Jiaotong University Health Science Center Xi'an Shaanxi China
5. College of Life Sciences Northwest University Xi'an Shaanxi China
Abstract
AbstractBackground and ObjectivesDiagnostic blood loss is a significant factor in the development of anaemia in neonates with very low birth weight. This study aimed to assess the clinical efficacy of intervention approaches involving varying diagnostic blood loss and red blood cell transfusion volumes in neonates with very low birth weights experiencing anaemia during hospitalization.Materials and MethodsA total of 785 newborns with anaemia weighing less than 1500 g were enrolled from 32 hospitals in China. The study involved monitoring diagnostic blood loss and red blood cell transfusion and evaluating relevant interventions such as red blood cell transfusion and clinical outcomes. Three intervention approaches were established based on the difference between blood loss and transfusion (Intervention Approaches 0, 1 and 2). The primary outcomes measured were unsatisfactory weight gain during hospitalization and neonatal mortality. The secondary outcomes included related complications.ResultsIn the non‐hospital‐acquired anaemia group, Intervention Approach 2 had the highest incidence of below‐normal weight gain (odds ratio [OR]: 3.019, 95% confidence interval [CI]: 1.081–8.431, p = 0.035). Multivariate analysis revealed that Intervention Approach 1 had a protective effect on weight gain. In the hospital‐acquired anaemia group, Intervention Approach 2 had the highest incidence of below‐normal weight gain (OR: 3.335, 95% CI: 1.785–6.234, p = 0.000) and mortality (OR: 5.341, 95% CI: 2.449–11.645, p = 0.000), while Intervention Approach 1 had the lowest incidence of intraventricular haemorrhage. Intervention Approach 1 demonstrated favourable outcomes in both anaemia groups.ConclusionIntervention Approach 1 improved weight gain and reduced mortality and complications in both the non‐hospital‐acquired and hospital‐acquired anaemia groups.