Am J Perinatol 2016; 33 - A021
DOI: 10.1055/s-0036-1592392

Effect of Anemia and Transfusion on Intestinal- Liver-Type Fatty-Acid-Binding Protein in Preterm Infants

B. Ozcan 1, O. Aydemir 2, D. U. Isık 1, N. Demirel 1, A. Y. Bas 1
  • 1Department of Neonatology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
  • 2Department of Neonatology, Eskisehir Osman Gazi University Medical School, Eskisehir, Turkey

Presenter: B. Ozcan (e-mail: drbeyzaozcan@gmail.com)

Introduction: Recent publications suggest a consistent and significant temporal association between necrotizing enterocolitis (NEC), anemia, and red blood cell (RBC) transfusions, but the mechanism how anemia and transfusion cause NEC, is not clear. Both of them are the reasons of intestinal injury. Fatty acid-binding protein (FABP) has been proposed as a plasma marker for the detection of acute intestinal injury recently. In this study, we aimed to compare the levels of serum intestinal FABP (IFABP) and liver FABP (LFABP) before and after blood transfusion and also compare the results with the patients who does not need transfusion.

Materials and Methods: This prospective study was conducted between May 2013 and 2014. A total of 59 stable growing preterm infants with gestational age (GA) < 32 weeks and/or birth weight (BW) <1,500 g who were older than 15 days postnatal age were enrolled. The study group included infants requiring erythrocyte transfusion for anemia and control group include the infants who did not require erythrocyte transfusion and have a hemoglobin value ≥10 g/dL. IFABP and LFABP levels of the study group before transfusion were compared with levels of the control group. IFABP and LFABP levels of the study group before transfusion were also compared with the levels after transfusion.

Results: Thirty-nine patients transfused for anemia (group 1) and 20 controls (group 2) were enrolled. Patients transfused for anemia had higher incidence of RDS (p = 0.001) and their hemoglobin levels (p < 0.001) were significantly lower compared with controls. LFABP (p < 0.001) levels were significantly higher in Group 1 compared with controls, whereas IFABP (p = 0.695) was not different. In the study group, IFABP levels significantly decreased (p < 0.05), but LFABP levels did not change after transfusion.

Conclusion: Serum levels of LFABP, which is considered injury markers of the intestine, were higher in the patients with anemia, compared with neonate without anemia. These results supported that severe anemia may be related with intestinal damage.

Keywords: transfusion, prematurity, fatty acid-binding protein, anemia