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Indian Pediatr 2016;53: 537-538 |
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Transfusion-associated Necrotizing
Enterocolitis: Authors’ Reply
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Parvesh M Garg and *Prem Shekhawat
Department of Pediatrics, Division of Neonatology,
Metro Health Hospital,
Case Western Reserve University,
2500 Metro Health Drive, Room R 249A, Cleveland,
Ohio 44109, USA.
Email:
[email protected]
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We agree that association between packed red blood cell (PRBC)
transfusion and necrotizing enterocolitis (NEC) has been reported
multiple times over the past 20 years but investigators are still
hard-pressed to provide a cause-and-effect relationship between the two
entities. During the publication process, several revisions of our data
were made, and somehow surgical NEC data and blood group data were
omitted from our final published results. In our study, out of 26
transfusion-associated NEC cases, 10 (39%) had stage 2a + 2b NEC and 16
(61%) had stage 3a + 3b cases (P = 0.04), while from control
(non-transfusion related NEC) group 45 (61.6%) had stage 2 NEC and 28
cases were of stage 3a + 3b NEC, which was statistically significant. B+
blood group was present in 31% of transfusion-associated NEC and only in
9% of non-transfusion associated NEC cases. This relationship did not
reach statistical significance (P=0.07).
The mortality rate mentioned in the abstract section
has been adjusted for gestational age, birthweight and gender. After
rechecking our data, the number of males in the transfusion associated
NEC group were 15 instead of 5, which was not statistically significant.
We agree with your contention that association between NEC and blood
transfusion should be studied in prospective multi-center randomized
trials with control of all confounders.
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