Background Preterm infants often require red cell transfusions (RCT) during their neonatal unit stay. Recently many studies have focussed on reducing the transfusion requirements e.g. delayed cord clamping, cord milking. Majority of these studies do not include the preterm infants that are of twin or higher order. This study was designed to investigate if the transfusion requirements in twins were different from singletons.

Method Retrospective data was collected from patient records for preterm infants below 32 weeks gestation admitted to regional tertiary neonatal unit at Nottingham City Hospital from October 2011 to February 2013. We compared transfusion requirements in singletons versus neonates of twin or higher order. All infants, singletons or twins, received similar neonatal care in terms of nutrition, supplements and thresholds for RCT.

Results A total of 113 infants (37 twins group and 76 singleton group) were identified at gestation below 32 weeks. Groups were comparable in terms of weight, sex distribution, haemoglobin at admission and mode of delivery.

48.6% of preterm twin and higher order infants required RCT compared to 53.9% of singleton infants (p = 0.6892) and on an average requiring 1 transfusion compared to 1.4 RCT per infant who were singleton. Outcomes at 6 weeks were comparable between the 2 groups.

Conclusion We conclude that preterm twin and higher order infants have comparable RCT requirements to singleton infants. This emphasises the need to focus on strategies to impact on the use of RCT in this population subgroup.

Ackowledgements PD Dr Heike Rabe for her guidance in planning the study.