Effect of hemoglobin on transfusion and neonatal adaptation in extremely low‐birthweight infants

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Abstract
The aim of the present paper was to investigate the effect of initial hemoglobin level on red blood cell transfusion and neonatal adaptation in extremely low-birthweight (ELBW) infants. Subjects consisted of 54 ELBW infants admitted to level III neonatal intensive care unit between 1995 and 2000, and divided into two groups based on hemoglobin level at birth. High hemoglobin was defined as hemoglobin > or =15.0 g/dL. There were no significant differences in gestational age and birthweight between the high hemoglobin group (n = 28) and low hemoglobin group (n = 26). The high hemoglobin group had decreased probability of requiring red blood cell transfusion (P < 0.05) and number of red blood cell transfusions (P < 0.05). Mortality rate in the low hemoglobin group was significantly higher compared with the high hemoglobin group (P = 0.03). In the high hemoglobin group, blood pressures during the first 24 h were significantly higher (P < 0.05) and the risk of intraventricular hemorrhage was significantly lower (P = 0.04) compared with the low hemoglobin group. The predictive variables, initial hemoglobin level (odds ratio 1.93 [decrease by 1 g/dL]) and intraventricular hemorrhage > or =III (odds ratio 21.76 [positive]) were found to be most predictive for death on logistic regression. High hemoglobin level at birth is associated with a significantly reduced requirement for red blood cell transfusion and might contribute to stabilization of blood pressure, and thus reduce mortality and the risk of severe intraventricular hemorrhage.