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Children
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Advances in Neonatal Transfusion: Risk Factors and Outcome
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Advances in Neonatal Transfusion: Risk Factors and Outcome

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: closed (5 June 2026) | Viewed by 2393

Editors

Dr. Chiara Maddaloni

E-Mail Website
Guest Editor
Neonatal Intensive Care Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Interests: critical care medicine; hematology; infectious diseases; neuroimaging; pediatrics
Dr. Srinivas Bolisetty

E-Mail Website
Guest Editor
Division of Newborn Services, Royal Hospital for Women, Randwick, NSW, Australia
Interests: neonatal medicine; neonatal intensive care; neonatology; infant nutrition; neonatal sepsis; neonatal resuscitation

Special Issue Information

Dear Colleagues,

Neonatal transfusion practices have become an essential part of neonatal intensive care, especially for preterm and critically ill infants who frequently require blood product support due to anemia, bleeding, or coagulopathies. Unlike adults, neonates present unique physiological challenges that influence transfusion decisions, and while advances have led to improved protocols, significant variability and knowledge gaps remain. This Special Issue aims to present current research on neonatal transfusion, with a focus on risk factors, clinical indications, and short- and long-term outcomes. We highlight cutting-edge studies addressing safety, efficacy, and individualized approaches to transfusion therapy. We are soliciting original research, reviews, and clinical or translational studies that contribute to optimizing transfusion strategies and improving neonatal outcomes.

We look forward to receiving your contributions.

Dr. Chiara Maddaloni
Dr. Srinivas Bolisetty
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neonatal transfusion
  • preterm infants
  • risk factors
  • outcomes
  • red blood cells
  • platelets
  • plasma
  • transfusion thresholds
  • neonatal intensive care

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Published Papers (2 papers)

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Research

10 pages, 1148 KB  
Article
Short-Term Physiological Effects of Red Blood Cell Transfusion in Very Low Birth Weight Infants: A Retrospective Cohort Study
by Charlotte Aßmann, Philipp Deindl, Martin E. Blohm, Dominique Singer and Ahmed Aboalqez
Children 2026, 13(6), 830; https://doi.org/10.3390/children13060830 - 18 Jun 2026
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Abstract
Background/Objectives: While packed red blood cell transfusions are commonly administered in anemic neonates, transfusion strategies in preterm infants have been the subject of debate for decades, particularly due to questionable long-term benefits and limited evidence regarding short-term physiological effects. In non-intubated preterm [...] Read more.
Background/Objectives: While packed red blood cell transfusions are commonly administered in anemic neonates, transfusion strategies in preterm infants have been the subject of debate for decades, particularly due to questionable long-term benefits and limited evidence regarding short-term physiological effects. In non-intubated preterm infants, established transfusion thresholds are considered, but individual clinical judgment often plays an important role in the final decision. This study aims to assess the short-term cardiorespiratory effects of red blood cell transfusions in non-intubated very-low-birth-weight (VLBW) infants who were either spontaneously breathing or receiving non-invasive respiratory support. Methods: Retrospective, single-center analysis of 68 VLBW infants (<1500 g) who received 99 red blood cell transfusions between 2019 and 2023. Cardiorespiratory parameters were observed over a 24 h period before and after transfusion. Results: Following transfusion, there was a significant decrease in the frequency of bradycardia events per 24 h (6.51 ± 5.55 to 4.24 ± 3.8; p = 0.004), accompanied by an improvement in the depth of oxygen desaturations (78.7 ± 4.18 to 81.0 ± 3.71; p = 0.001). No significant changes were detected in the desaturation frequency, FiO2 or heart rate. Conclusions: In clinically stable very-low-birth-weight infants receiving non-invasive ventilatory support, packed red blood cell transfusion is associated with modest, short-term improvements in cardiorespiratory stability. However, these effects are limited in scope. Further research is needed to identify which patient subgroups derive the most significant benefit from these transfusions. Full article
(This article belongs to the Special Issue Advances in Neonatal Transfusion: Risk Factors and Outcome)
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12 pages, 764 KB  
Article
Changes in Fetal Hemoglobin in Very Preterm Infants Born Small for Gestational Age: A Retrospective Observational Study
by Carlo Dani, Federico Cipriani, Maria Ciavotta and Giulia Remaschi
Children 2026, 13(1), 117; https://doi.org/10.3390/children13010117 - 13 Jan 2026
Cited by 2 | Viewed by 1611
Abstract
Background: Small-for-gestational-age (SGA) preterm infants are at higher risk for oxidative stress-related complications than appropriate-for-gestational-age (AGA) preterm infants. It has been proposed that HbF may be higher in SGA than in AGA infants due to fetal hypoxia. Aim: The aim of this study [...] Read more.
Background: Small-for-gestational-age (SGA) preterm infants are at higher risk for oxidative stress-related complications than appropriate-for-gestational-age (AGA) preterm infants. It has been proposed that HbF may be higher in SGA than in AGA infants due to fetal hypoxia. Aim: The aim of this study was to compare postnatal changes in HbF fractions in very preterm SGA and AGA infants and in subgroups of these patients who had been transfused with red blood cells (RBCs) or not. Methods: We studied 30 SGA and 60 AGA very preterm infants with a gestational age of 27.7 ± 1.6 and 27.9 ± 0.7 weeks, respectively. HbF fractions were recorded daily during the first week of life, at 14 ± 2, 21 ± 2, and 28 ± 2 days of life, and 36 weeks (±3 days of life) of postmenstrual age. Results: The HbF fractions measured from the first day of life to the 36th week of postmenstrual age decreased significantly in both the groups, without differences between the groups. Transfused and non-transfused SGA infants had similar values of HbF fraction, while transfused AGA infants had lower values of HbF fraction than non-transfused infants. Conclusions: HbF fraction decreased similarly in the postnatal period in very preterm SGA and AGA infants. RBC transfusions did not affect hemoglobin fraction (HbF) values in SGA infants but were associated with a reduction in HbF in AGA infants. These findings may be due to the effect of fetal preconditioning hypoxia in very preterm SGA infants. Full article
(This article belongs to the Special Issue Advances in Neonatal Transfusion: Risk Factors and Outcome)
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