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The number of blood transfusions received and the incidence and severity of chronic lung disease among NICU patients born >31 weeks gestation

Journal of Perinatology volume 45, pages 218–223 (2025)Cite this article

Subjects

Abstract

Objective

We previously reported the possible pathogenic role, among infants born ≤29 weeks, of transfusions in bronchopulmonary dysplasia. The present study examined this association in infants born >31 weeks.

Study design

Analysis of red blood cell (RBC) and platelet transfusions in five NICUs to infants born >31 weeks, and chronic neonatal lung disease (CNLD) at six-weeks of age.

Results

Seven-hundred-fifty-one infants born >31 weeks were still in the NICU when six-weeks of age. CNLD was identified in 397 (53%). RBC and platelet transfusions were independently associated with CNLD after controlling for potential confounders. For every transfusion, the adjusted odds of developing CNLD increased by a factor of 1.64 (95% CI, 1.38–2.02; p < 0.001).

Conclusions

Among NICU patients born >31 weeks, transfusions received by six weeks are associated with CNLD incidence and severity. Though we controlled for known confounding variables in our regression models, severity of illness is an important confounder that limits our conclusions.

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Fig. 1: Consort diagram.
Fig. 2: Lung disease severity stratified by number of transfusions.

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Data availability

A deidentified data set is available by contacting the corresponding author.

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Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA

    Timothy M. Bahr, Robin K. Ohls, Bradley A. Yoder & Robert D. Christensen

  2. Department of Neonatology, Intermountain Health, Murray, UT, USA

    Timothy M. Bahr, Erick Henry & Robert D. Christensen

  3. Division of Newborn Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    Patricia Davenport & Martha C. Sola-Visner

  4. Transfusion Services and Department of Pathology, Intermountain Health, Murray, UT, USA

    Sarah J. Ilstrup

  5. American National Red Cross, Salt Lake City, UT, USA

    Walter E. Kelley

  6. Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, USA

    Walter E. Kelley

Authors
  1. Timothy M. Bahr
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  2. Robin K. Ohls
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  3. Erick Henry
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  4. Patricia Davenport
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  5. Sarah J. Ilstrup
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  6. Walter E. Kelley
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  7. Bradley A. Yoder
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  8. Martha C. Sola-Visner
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  9. Robert D. Christensen
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Contributions

TMB: Conceptualization, methodology, statistical analysis, data curation, writing-review & editing, final approval of the manuscript. RKO: Conceptualization, writing—review & editing, final approval of the manuscript. EH: Conceptualization, data curation, final approval of the manuscript. PD: Writing—review & editing, final approval of the manuscript. SJI: Conceptualization, data curation, writing-review & editing, final approval of the manuscript. WEK Conceptualization, writing—review & editing, final approval of the manuscript. BAY: Conceptualization, writing—review & editing, final approval of the manuscript. MCS-V; Writing—review & editing, final approval of the manuscript. RDC: Conceptualization, methodology, data curation, writing—original draft, writing—review & editing, final approval of the manuscript.

Corresponding author

Correspondence to Timothy M. Bahr.

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Competing interests

The authors declare no competing interests.

Ethics approval

The Institutional Review Board of Intermountain Health approved the proposal for this data-only retrospective analysis and determined this to be exempt from the need for individual informed consent (IRB# 1052045). All study activities were performed in accordance with Intermountain Health IRB and privacy guidelines and regulations.

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Bahr, T.M., Ohls, R.K., Henry, E. et al. The number of blood transfusions received and the incidence and severity of chronic lung disease among NICU patients born >31 weeks gestation. J Perinatol 45, 218–223 (2025). https://doi.org/10.1038/s41372-024-02135-7

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