Association of low hemoglobin at birth and neurodevelopmental outcomes in preterm neonates ≤28 weeks’ gestation: A retrospective cohort study

Abstract Objective To compare neurodevelopmental outcomes at 18–24 months corrected age (CA) for preterm infants who had hemoglobin levels < 120 gm/l versus those with hemoglobin level ≥ 120 gm/l at birth.Methods We included infants of ≤ 28 weeks gestational age (GA) born between January 2009 and June 2018. The primary outcome was neurodevelopmental impairment (NDI) at 18–24 months. Multivariable logistic regression was applied to determine the association.Results Of the 2351 eligible neonates, 351 (14.9%) had hemoglobin levels < 120 gm/L at birth. Of the 2113 surviving infants, 1534 (72.5%) underwent developmental follow-up at 18 to 24 months CA. There was no statistically significant difference in ND outcomes between the two groups. The composite outcome of death or NDI was significantly higher in the low hemoglobin group.Conclusion In preterm infants ≤ 28 weeks GA, initial hemoglobin < 120 gm/L at birth was not associated with neurodevelopmental impairment at 18–24 months CA among survivors.