King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Science, Department of Pediatrics, King Abdulaziz Hospital, Ministry of National Guard Hospital, Al-Ahsa, Saudi Arabia
Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
Neonatology Division, Foothills Medical Center, University of Calgary, Calgary, Canada
Address for correspondence: Dr. Sameer Al-Abdi, Department of Pediatrics, King Abdulaziz Hospital, Ministry of National Guard Hospital, PO Box 2477, Al-Ahsa 31982, Saudi Arabia. Tel.: +966135338079; Fax: +966 593333/Ext. 33844; E-mail: firstname.lastname@example.org.
Abstract: BACKGROUND:Contradictory evidence exists whether a prophylactic coagulation factor transfusion in the first hours of life (HOL) prevents intraventricular hemorrhage (IVH) in extreme preterm infants (EPI, <28 weeks gestation). We aimed to determine whether selective prophylactic solvent-detergent plasma and cryoprecipitate transfusion within 12 hours of life (SP-SDP/Cryoprecipitate-T) could prevent IVH in EPI. METHOD:This is a retrospective analysis, case-historical control, of prospectively collected data from a pre-existing electronic neonatal database at a Saudi tertiary neonatal intensive care unit. We compared the IVH rate in EPI born in the first 4 years (Jan 2010–Dec 2013) of the SP-SDP/Cryoprecipitate-T period with that of EPI born during the last 4 years (Jan 2006–Dec 2009) of the rescue SDP/Cryoprecipitate-T period. RESULTS:The IVH rate was lower in the SP compared to the rescue- SDP/Cryoprecipitate-T period (30.8% versus 51.2%, odds ratio 0.42, 95% confidence interval 0.21, 0.88, p = 0.02). This difference remained significant after controlling for six other IVH risk factors. CONCLUSIONS:Early SP-SDP/Cryoprecipitate-T may reduce the IVH rate in EPI. A large multicenter clinical trial is required for confirm the short and long-term benefit and risk of this intervention. Until then, early SP-SDP/Cryoprecipitate-T may be considered by an institution with a persistently high IVH rate.