Related Experiment Video
Updated: Nov 7, 2025
A Rat Model of Mild Intrauterine Hypoperfusion with Microcoil Stenosis
Published on: January 7, 2018
Effect of blood transfusions on cognitive development in very low birth weight infants
Priya Shah1, Daniel C Cannon2, Jean R Lowe3
1Presbyterian Medical Group, Pediatrics, Albuquerque, NM, USA.
Insights
Red blood cell transfusions in preterm infants may impact early cognition. Erythropoiesis stimulating agents (ESAs) appeared to mitigate negative effects, suggesting potential neuroprotection in transfused infants.
Area of Science:
- Neonatal Medicine
- Developmental Neuroscience
- Pediatric Hematology
Background:
- Preterm infants often require red blood cell transfusions.
- The impact of these transfusions on cognitive development remains unclear.
- Erythropoiesis stimulating agents (ESAs) are used in preterm infants, but their neuroprotective effects are under investigation.
Purpose of the Study:
- To investigate the relationship between red blood cell transfusions and cognitive outcomes in preterm infants.
- To determine if ESAs influence cognitive development in transfused preterm infants.
Main Methods:
- A randomized trial comparing ESAs and placebo in preterm infants during hospitalization.
- Recording of transfusion data for all participants.
- Cognitive assessments using standard developmental tests at 18-22 months and 3.5-4 years of age.
Main Results:
- Cognitive scores at 18-22 months showed an inverse correlation with transfusion volume (p=0.02).
- Preterm infants receiving ESAs and at least one transfusion had significantly higher cognitive scores than placebo (p=0.003).
- No significant correlation between transfusions and cognitive scores was observed at 3.5-4 years.
Conclusions:
- In preterm infants not receiving ESAs, transfusions were associated with lower cognitive scores at 18-22 months.
- In preterm infants treated with ESAs, transfusion status did not affect cognitive scores, suggesting a potential neuroprotective role for ESAs.
- ESAs may offer neuroprotection against potential adverse cognitive effects of red blood cell transfusions in preterm infants.
Objective:
Preterm infants frequently receive red cell transfusions; however, the effect of transfusions on cognition is unclear. We evaluated the relationship between transfusions and cognitive outcomes in preterm infants enrolled in a randomized trial of erythropoiesis stimulating agents (ESAs).
Study Design:
Preterm infants were randomized to ESAs or placebo during initial hospitalization, and transfusions recorded. Children were evaluated using standard developmental tests of cognition at 18-22 months (56 ESA, 24 placebo) and 3.5-4 years (39 ESA, 14 placebo).
Results:
Cognitive scores at 18-22 months were inversely correlated with transfusion volume (p = 0.02). Among those receiving ≥1 transfusion, cognitive scores were significantly higher in the ESA-treated group (p = 0.003). At 3.5-4 years, transfusions were not correlated with cognitive scores.
Conclusions:
In the placebo group, transfused children had lower cognitive scores than did non-transfused children at 18-22 months. In the ESA group, cognitive scores did not differ by transfusion status, suggesting ESAs might provide neuroprotection.
Related Concept Videos
01:29Environmental Influences on Intelligence
01:30Information Processing Approach
01:30Biological Influences on Intelligence
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
01:19Rh Blood Group