Systematic review and meta-analysis links pRBC transfusion to NEC deterioration in neonates
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Key Takeaway
Note potential association between pRBC transfusion and NEC deterioration in this meta-analysis.
This systematic review and meta-analysis evaluates the relationship between packed red blood cell (pRBC) transfusion and clinical deterioration in neonates with necrotizing enterocolitis. The authors synthesized data from a small number of eligible studies included in this meta-analysis, focusing on the primary outcome of clinical deterioration of NEC.
The analysis reported a potential association between pRBC transfusion and clinical deterioration with an odds ratio of 6.05. The 95% confidence interval for this association ranged from 3.02 to 12.14. No secondary outcomes were reported in the synthesis.
Safety data regarding adverse events, serious adverse events, discontinuations, or tolerability were not reported. The authors note that the small number of eligible studies included in this meta-analysis is a key limitation. Causal relationships and clinical deterioration must not be overstated based on these observational findings.
Future large-scale, well-designed studies are needed to confirm the observed association. Practice relevance remains uncertain until further evidence clarifies the risk profile of pRBC transfusion in this specific population.
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View Original Abstract ↓
BACKGROUND: No systematic review has evaluated the existing evidence regarding the association between packed red blood cell (pRBC) transfusion and clinical worsening of necrotizing enterocolitis (NEC) in neonates. This systematic review and meta-analysis was conducted to address this knowledge gap.
MATERIALS AND METHODS: We searched the Cochrane Library, EBSCO, Embase, Web of Science, Google Scholar, and PubMed for studies on pRBC transfusion and NEC published before May 10, 2025. Relevant articles were selected through title, abstract, and full-text screening. English-language case-control studies or cohort studies, or randomized controlled trials involving newborns with NEC that compared pRBC transfusion with no transfusion and reported changes in NEC clinical status were included. Review articles, systematic reviews, case reports, editorials, animal studies, duplicate publications, and studies with incomplete data were excluded.
RESULTS: Five studies involving 971 neonates with NEC were included. The pooled analysis demonstrated a potential association between pRBC transfusion and clinical deterioration of NEC in neonates (odds ratio: 6.05, 95% confidence interval: 3.02-12.14).
CONCLUSIONS: pRBC transfusion was associated with an exacerbation of NEC in neonates. However, these findings should be interpreted cautiously because of the small number of eligible studies included in this meta-analysis, and future large-scale, well-designed studies are needed to confirm the observed association.
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