Background Previous reports of transfusion practices in neonates have focused predominantly on premature neonates admitted to neonatal intensive care units (NICU). Population data on neonatal transfusions is limited.
Methods This study used linked population-based data from New South Wales (NSW) birth and hospital discharge data to determine rates of blood and blood product transfusion in the first 28 days of life. The study included all livebirths of at least 23 weeks gestation in NSW between 2001 and 2011, providing data on one-third of all Australian births.
Results Of 989491 livebirths, 6436 received a blood product transfusion (6.5 per 1000 births). 56% were born < = 32 weeks gestation (n = 3594, 272/1000 births) and 44% were >32 weeks gestation (n = 2842, 2.9/1000 births). 8% received transfusions in a hospital without a neonatal or paediatric ICU.
The rate of transfusions of blood and blood products in neonates increased between 2001 and 2011 (5.7/1000 to 7.0/1000, p < 0.001).
High transfusion rates were seen in neonates with a prior in-utero transfusion (667/1000), congenital anomaly requiring surgery (437/1000) or haemolytic disorder (132/1000). 48% received red cells alone, 29% received red cells plus other blood products and 24% received other blood products without red cells.
Conclusions High rates of transfusions are seen in preterm neonates and in those undergoing surgery or with haemolytic disorders. Rates of neonatal transfusion increased in NSW between 2001 and 2011, primarily due to reported increased use of plasma and gamma globulin.