Pattern, Complications and Social Problems of Blood Transfusion in the Neonatal Unit of a Tertiary Hospital in Southern Nigeria

Abstract

Introduction: Blood transfusion is a life-saving procedure best carried out as soon as it is recommended to avoid morbidity and mortality. Aim: To determine the Pattern, complications and social problems of blood transfusion in a neonatal unit in Southern Nigeria. Methodology: A prospective descriptive study of 179 neonates admitted in the neonatal unit of the Rivers State University Teaching Hospital over a period of 3years. Results: Out of 179 neonates for which blood transfusion was recommended, 172(96.1%) received blood transfusion whereas 7(3.9%) did not. Majority of the children transfused were preterm 144(80.4%), delivered via Caesarean section 108(60.3%) and weighed < 2.5kg 144(80.4%). Most were admitted in their first week of life 143(79.9%) with morbidity pattern for most babies transfused being prematurity, neonatal sepsis and neonatal jaundice. Most transfusions occurred after the first week of admission with first degree relatives 76(45.2%) and commercial donors being the most source of blood transfused. Non-availability of donors and compatibility issues were the commonest reasons for use of commercially donated blood. Most received single blood transfusion 72(71.2%), sedimented cells 160(89.3%) and within 24hours following its recommendation. The reasons for transfusion beyond 24hours were financial constraints 31(57.4%) and no donor 26(48.1%). Commonest reasons for not consenting to blood transfusion were social; financial constraint 4(57.1%) and religious reasons 2(28.6%). Only 1(0.6%) neonate had obvious blood transfusion reaction while 22(13.2%) had post transfusion malaria. Conclusion: Not all neonates who required blood transfusion received it. The commonest morbidity pattern among recipients were prematurity, neonatal sepsis and neonatal jaundice. Financial constraint was the commonest reason for both delayed blood transfusion and for not consenting to blood transfusion thus policies must be made to ensure ready availability and accessibility of blood in hospitals including the National Health Insurance Scheme in order to reduce neonatal morbidity and mortality.