Association between hemoglobin concentrations at discharge from the neonatal intensive care unit with markers of neurodevelopmental outcomes in premature neonates

Article type: Research Article

Authors: Kratimenos, Panagiotis^{a; b; *} | Christidis, Panagiotis^c | Kehinde, Folasade^a | Koutroulis, Ioannis^d | Santana, Stephanie^e | Mossabeb, Roschanak^a | Fleishman, Rachel^f

Affiliations: [a] Drexel University College of Medicine, St. Christopher’s Hospital for Children and Temple University Hospital, Philadelphia, PA, USA | [b] Department of Pediatrics, Division of Neonatology, Children’s National Medical Center, George Washington University, School of Medicine and Health Sciences, Washington, DC, USA | [c] Aristotle University of Thessaloniki, School of Medicine, Thessaloniki, Greece | [d] Department of Pediatrics, Division of Emergency Medicine, Children’s National Medical Center, George Washington University, School of Medicine and Health Sciences, Washington, DC, USA | [e] Nemours/AI DuPont Hospital for Children, Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, DE, USA | [f] Children’s Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

Correspondence: [*] Address for correspondence: Panagiotis Kratimenos, Neonatology, Children’s National Medical Center, Center for Research in Neuroscience, Children’s Research Institute, George Washington University. 111 Michigan Avenue, NW, Washington, DC 20010 P 202 602 4889 E-mail: [email protected].

Abstract: BACKGROUND:Premature neonates are often subjected to multiple transfusions with red blood cells during their hospitalization in the neonatal intensive care unit (NICU). The hemoglobin threshold for transfusion prior to discharge from the NICU varies significantly among different centers. The aim of the present study is to investigate the association between hemoglobin concentration at discharge with neurodevelopmental outcomes in premature neonates. METHODS:Retrospective observation study with regression analysis was performed with follow up assessment in the neuro-developmental outpatient clinic at 30 months of adjusted age. RESULTS:Data from 357 neonates born at less than 37 weeks’ gestation were analyzed. Sensory and motor neurodevelopment at 30 months of adjusted age, were not associated with the hemoglobin concentration at discharge (p=0.5891 and p=0.4575, respectively). There was no association between the hemoglobin concentration at discharge with fine or gross motor development (p=0.1582 and p=0.3805, respectively). Hemoglobin concentration at discharge was not associated with poor neurodevelopmental outcomes up until 30 months of adjusted age. CONCLUSIONS:The data of the present study indicate that the hemoglobin concentration of premature neonates at the time of discharge is not associated with poorer markers of neurodevelopmental outcomes at 30 months of adjusted age. Comorbidities such as BPD and IVH that are present to premature neonates were identified as potential risk factors for certain aspects of the neurodevelopment.

Keywords: Hemoglobin, discharge, neurodevelopment, transfusion, NEC, premature neonates, NICU

DOI: 10.3233/NPM-1822

Journal: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 2, pp. 221-230, 2019