Intermountain Health Study Shows How to Best Reduce Need for Blood Transfusions in Premature Babies

A new study published in the Journal of Perinatology is helping premature babies avoid blood transfusions, thanks to new research and collaboration between researchers at Intermountain Health and the University of Utah.

Timothy Bahr, MD, an Intermountain Health neonatologist and researcher, collaborated with Robert Christensen, MD, and Robin Ohls, MD, from University of Utah Health, to explore the dosage and frequency needed of a medication called darbepoetin (darbe), which boosts red blood cell production in premature infants.

Premature babies often suffer from low red blood cell counts (anemia), which can contribute to various complications such as developmental delays and difficulty breathing.

Subcutaneous injections of darbe have been used to effectively treat anemia of prematurity and boost red blood cell production in premature infants, to help decrease the need for red blood cell transfusions in the United States for the past 20 years.

The goal of the study was to refine the dosage and frequency of darbe to these vulnerable babies, so it provides optimal health benefits, along with the minimum necessary number of subcutaneous injections.

Dr. Bahr and his collaborators, who have been at the forefront of research on treatment for anemia in premature babies, conducted their study at Intermountain Medical Center in Murray and Intermountain Utah Valley Hospital in Provo.

The study tested two different dosing schedules: injections once a week and once every two weeks.

The results were promising.

“We found that while weekly doses of darbe increased red blood cell production slightly more, both schedules resulted in similar overall health outcomes for the babies,” said Dr. Bahr. “This means that giving Darbe every two weeks could be a viable option, reducing the number of injections these infants need.”

“Fewer injections can lead to a more comfortable experience for premature babies and their parents, and it also could potentially lower healthcare and pharmacy costs,” he added.

According to neonatologists, when darbe improves red blood cell counts to more normal levels in premature infants, they are less likely to need a blood transfusion.

Some preemies need only darbe injections, while more severe newborn patients may also need a blood transfusion to help them be more likely to survive their stay in a neonatal ICU.

“Transfusions can be done safely and can be lifesaving for preemies, but they do come with some risks. If we can reduce the need for blood transfusions in preemies, we can also reduce their risk of complications which can occur after a blood transfusion,” said Dr Bahr.

According to Dr. Bahr, the transfusion rate of premature infants in Intermountain Health neonatal ICUs is well below the national average.

Intermountain’s use of darbe and its ongoing research into best practices for the medication over the last 20 years are all part of an effort to reduce the number of transfusions preterm babies require.

“Eliminating unnecessary blood transfusions at Intermountain Health or ‘transfusion stewardship’ is much like our antibiotic stewardship efforts, which promote responsible use of antibiotics and reduces unnecessary use and enhances patient care and outcomes,” said Dr. Bahr.

“This research study’s findings offer a potential new approach to administering darbepoetin to premature babies, providing a balance between effective treatment and the comfort of fewer medical interventions,” said Elizabeth O’Brien, MD, senior medical director for neonatal health at Intermountain Health. “This is one of the many ways Intermountain is working to enhance the health and well-being of premature infants and provide more advanced and compassionate care for these very young and vulnerable patients.”

Intermountain Primary Children’s Hospital is home to the leading Level IV Neonatal ICU in the Mountain West, and Intermountain has 17 other hospitals (10 in Utah) with a neonatal ICU.

Providers at all 20 Intermountain Health hospitals with labor and delivery units in Utah have access to virtual neonatologists 24 hours a day, seven days a week. Intermountain Health is nationally recognized for the unique ability to provide this high-level of neonatal telemedicine to rural hospitals.

About Intermountain Health

Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a not-for-profit system of 34 hospitals, approximately 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For up-to-date information and announcements, please see the Intermountain Health newsroom at https://intermountainhealthcare.org/news.