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Radiation exposure in extremely low birth weight infants during their neonatal intensive care unit stay
Narayan Prabhu Iyer, Amy Baumann, Mark Stephen Rzeszotarski, Robert Donald Ferguson, Maroun Jean Mhanna
Cleveland, Ohio, USA
Author Affiliations: Department of Pediatrics (Iyer NP, Baumann A, Mhanna MJ), and Department of Radiology (Rzeszotarski MS, Ferguson RD), MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
Corresponding Author: Maroun Jean Mhanna, MD, MPH, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, Ohio 44109, USA (Tel: 216-778-1346; Fax: 216-778-4223; Email: mmhanna@metrohealth.org)
doi: 10.1007/s12519-013-0417-1
Background: Extremely low birth weight (ELBW <1000 g) infants may have increased sensitivity to radiation exposure. Our objective was to estimate the radiation exposure in survivors of ELBW infants during their neonatal intensive care unit (NICU) stay.
Methods: In this retrospective cohort study, medical records of all ELBW infants who had been admitted to our NICU between May 1999 and October 2009 were reviewed. The infants' total entrance skin exposure [ESE in micro-Gray (µGy)] was estimated.
Results: Among 450 survivors, the mean gestational age (GA) was 26.3¡À2.1 weeks, and the mean birth weight (BW) was 774.2¡À144.4 g. Infants received a median of 32 (range: 1-159) X-rays, with an estimated ESE of 1471 µGy (range: 28-9264). Total ESE was inversely proportional to GA (r=-0.34; P<0.01), and BW (r=-0.39; P=0.01) and proportional to the severity of illness [score for neonatal acute physiology-perinatal extension (SNAPPE), r=0.39; P=0.01]. In a linear regression analysis, GA, SNAPPE and necrotizing enterocolitis were associated with radiation exposure (ESE) in ELBW infants (r2=0.133; P<0.001).
Conclusions: During their NICU stay, ELBW infants were subjected to a significant number of diagnostic X-ray procedures. Our data highlight the need to closely monitor the number of X-ray procedures ordered to ELBW infants to avoid unnecessary radiation exposure.
Key words: entrance skin exposure; extremely low birth weight infants; radiation exposure
World J Pediatr 2013;9(2):175-178
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