Providing premature babies with a higher red blood cell threshold within accepted limits provides no benefit in terms of survival or reducing neurological damage, according to a new study.
- In France, premature babies represent 8% of births
- Transfusion to raise the hemoglobin threshold aims to combat the risk of anemia
- This practice would not provide any benefit in terms of survival or neurological development.
Every year, some 15 million babies are born prematurely worldwide. Or before 37 weeks of gestation. At the origin of nearly a million deaths per year, complications of premature births are the leading cause of death among children under five, according to the World Health Organization (WHO). The risks are even greater for very premature infants (born before 29 weeks of pregnancy) and those weighing less than 1,000 grams. They are at high risk of anemia due to their early stage of development, reduced ability to produce red blood cells and the need to receive more blood samples as part of their intensive medical care. However, according to a new study published on Thursday 31 December in the New England Journal of Medicineproviding premature babies with a higher red blood cell threshold within accepted limits provides no benefit in terms of survival or reduction of neurological impairment.
For their study, researchers from the University of Pennsylvania in the United States, followed 1824 infants. Of 845 babies affected with a higher hemoglobin threshold, 50.1% died or survived but with neurodevelopmental impairment compared to 49.8% of the 847 infants affected with a lower threshold. Assessing the results of the two components separately, the researchers found similar rates of death (16.2% versus 15%) and neurodevelopmental impairment (39.6% versus 40.3%).
“In extremely low birth weight infants, a higher hemoglobin threshold for red blood cell transfusion did not improve survival without neurodevelopmental impairment at 22–26 months of age, corrected for prematurity” , conclude the researchers.
Children weakened for several years
These new results therefore contradict those of past studies which suggested that anemic infants who were given a transfusion leading to higher hemoglobin thresholds would have a lower risk of death, cognitive delay, cerebral palsy and loss of memory. hearing and vision.
In France, a premature baby is born every eight minutes, or 8% of annual births. According to a British study also published in the British Medical Journal in November, the risks of fragility for these children persist until the age of ten. Indeed, their work showed that for babies born too early, the risk of hospital admission was about six times higher than for others. By the time the children were 7 to 10 years old, this hospitalization rate was still three times higher than for those born at 40 weeks’ gestation. Among the causes of admission detected, the researchers first noted infections contracted during early childhood. During the first two years of a preterm infant’s life, respiratory and gastrointestinal conditions are also an important risk factor.
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