Am J Perinatol 2020; 37(06): 603-606
DOI: 10.1055/s-0039-1683982
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Severe Anemia Is Associated with Intestinal Injury in Preterm Neonates

1  Department of Neonatology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
,
Ozge Aydemir
2  Faculty of Medicine, Department of Neonatology, Eskişehir Osmangazi University, Eskisehir, Turkey
,
Dilek Ulubas Isik
1  Department of Neonatology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
,
Ahmet Yagmur Bas
3  Department of Neonatalogy, Yildirim Beyazit Universty Faculty of Medicine, Ankara, Turkey
,
Nihal Demirel
3  Department of Neonatalogy, Yildirim Beyazit Universty Faculty of Medicine, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

10 November 2018

23 February 2019

Publication Date:
04 April 2019 (online)

Abstract

Objective A temporal relationship has been reported between necrotizing enterocolitis, anemia, and red blood cell transfusion (RBCT) in preterm neonates. However, the mechanism underlying this association is not clearly defined. Intestinal (I-) and liver (L-) fatty acid binding proteins (FABPs) have been proposed as plasma markers for the detection of acute intestinal injury. This study aimed to investigate the effect of anemia and RBCT on intestinal injury in preterm neonates by measuring serum I-FABP and L-FABP levels.

Study Design A prospective cohort study including preterm neonates with gestational age <32 weeks and/or birth weight <1,500 g and requiring erythrocyte transfusions for anemia after day 15 of life was conducted. Stable growing preterm infants with hemoglobin values ≥ 10 g/dL were taken as controls. I-FABP and L-FABP levels of the neonates with anemia were compared with levels of the control group. In addition, pretransfusion I-FABP and L-FABP levels of the neonates with anemia were compared with posttransfusion levels.

Results In total, 39 infants transfused for anemia and 20 controls were enrolled. L-FABP levels were significantly higher in neonates with anemia compared with controls (p < 0.001), whereas I-FABP (p = 0.695) was not different. L-FABP and I-FABP levels were similar before and after transfusion in neonates with anemia. L-FABP levels before transfusion were negatively correlated with pretransfusion hemoglobin levels (p < 0.001).

Conclusion Anemia is associated with intestinal injury documented by increased L-FABP levels in preterm infants, and this injury is more severe with lower hemoglobin levels.