Association between red cell transfusions and necrotizing enterocolitis

Sachin C. Amin, Juan I. Remon, Girish C. Subbarao, Akhil Maheshwari

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


Objective: Several case reports and retrospective studies have reported a temporal association between red blood cell (RBC) transfusions and necrotizing enterocolitis (NEC). In this article, we review the clinical evidence and biological plausibility of the association between RBC transfusions and NEC. Methods: A literature search was performed using the databases PubMed, EMBASE, and Scopus, and the electronic archive of abstracts presented at the annual meetings of the Pediatric Academic Societies. Results: Among all cases of NEC, 25-40% patients were noted to have received an RBC transfusion within a 48 hour period prior to onset of NEC. Compared to infants who developed NEC unrelated to transfusion, neonates with transfusion-associated NEC were born at an earlier gestation, had lower birth weights, and had a delayed onset at 35 weeks of postnatal age. Conclusions: Based on current clinical evidence, transfusion-associated NEC appears to be a plausible clinical entity. However, there is a need for cautious interpretation of data because all the studies that have been conducted until date are retrospective, and therefore, susceptible to bias. A large, prospective, multi-center trial is needed to evaluate the association between RBC transfusion and NEC.

Original languageEnglish (US)
Pages (from-to)85-89
Number of pages5
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue numberSUPPL. 5
StatePublished - Oct 2012
Externally publishedYes


  • Anemia
  • Intestinal injury
  • NEC
  • RBC
  • Transfusion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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