[Meta-analysis of post-transfusion necrotizing enterocolitis in neonates].

OBJECTIVE: To quantitatively assess the association between transfusions and the risk of necrotizing enterocolitis (NEC) in neonates.

METHOD: Both Chinese and English literature published from Jan. 1985 to Nov. 2011 about the case-control study of the association between transfusions and neonatal NEC were retrieved by searching the electronic resource databases. A meta-analysis was then performed on the comparison and synthesis of findings from included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using RevMan 5.0 software. Sensitivity analysis was conducted and possible publication bias was tested as well.

RESULT: A total of 7 case-control studies (480 blood transfusion cases, 2845 control cases) were included. The meta-analysis with a random-effects model found a pooled OR of 3.35 (95% CI: 1.54-7.27). Sensitivity analysis showed that OR for post-transfusion NEC within 48 h was 4.21 (95% CI: 2.17-8.16). The OR was 4.29 (95% CI: 1.39-13.24) after factors such as gestational age and birth weight were de-confounded. The fail-safe number was 263.

CONCLUSION: Blood transfusion can increase the risk of NEC in neonates. The clinical application of this conclusion should be cautious due to limited reports. High-quality randomized control trials are still needed for the further proof of the association between blood transfusion and neonatal NEC.