{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:19:34Z","timestamp":1787015974194,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,9,7]],"date-time":"2016-09-07T00:00:00Z","timestamp":1473206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Controversy exists regarding the contribution of blood transfusions to a range of adverse clinical outcomes in neonates. The aim of our systematic review was to identify the broader literature on harmful effects and associations potentially attributable to red blood cell (RBC) transfusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN AND METHODS<\/jats:title>\n                    <jats:p>A comprehensive search of MEDLINE (PubMed) and EMBASE was undertaken. Eligible studies included both randomized controlled trials (RCTs) and nonrandomized studies examining the effects of small volume (10\u201020 mL\/kg) RBC transfusions on neonates. Primary outcomes of interest were mortality, chronic lung disease, retinopathy of prematurity, necrotizing enterocolitis, and intraventricular hemorrhage. Two independent authors conducted a review of abstracts and then of full\u2010text article reviews as well as data extraction and quality assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Sixty\u2010one studies were eligible for inclusion, including 16 (26%) randomized studies. The majority of studies were nonrandomized (n\u2009=\u200945; 74%), which included 32 observational studies with and 13 studies without a comparator group. There was no evidence that rates of mortality differed between restrictive and liberal strategies for transfusion (eight RCTs: risk ratio, 1.24; 95% confidence interval, 0.89\u20101.672, heterogeneity\u2009=\u20090%) or for necrotizing enterocolitis (five RCTs: risk ratio, 1.45; 95% confidence interval, 0.91\u20102.33; heterogeneity\u2009=\u20090%). A liberal strategy also was not superior to restrictive transfusion practice in the pooled randomized studies for rates of retinopathy of prematurity, chronic lung disease, or intraventricular hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Statistically significant differences in a range of harmful outcomes between neonates exposed to restrictive and liberal RBC transfusion practice were not found. However, the risks of bias identified in many studies and the lack of consistent reporting and definitions of events limits our conclusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.13785","type":"journal-article","created":{"date-parts":[[2016,9,7]],"date-time":"2016-09-07T11:19:45Z","timestamp":1473247185000},"page":"2773-2780","source":"Crossref","is-referenced-by-count":44,"title":["Adverse effects of red blood cell transfusions in neonates: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1692-5676","authenticated-orcid":false,"given":"Amy","family":"Keir","sequence":"first","affiliation":[{"name":"Robinson Research Institute and the School of Medicine University of Adelaide Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanchita","family":"Pal","sequence":"additional","affiliation":[{"name":"Rosie Neonatal Unit Cambridge University Hospitals NHS Foundation Trust Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marialena","family":"Trivella","sequence":"additional","affiliation":[{"name":"Centre for Statistics in Medicine, University of Oxford  United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lani","family":"Lieberman","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, University Health Network Toronto Canada"},{"name":"Department of Clinical Pathology Toronto Canada"},{"name":"Department of Laboratory Medicine &amp; Pathobiology, University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie","family":"Callum","sequence":"additional","affiliation":[{"name":"Transfusion Medicine and Tissue Banks, Sunnybrook Health Sciences Centre Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Shehata","sequence":"additional","affiliation":[{"name":"Departments of Medicine, and Laboratory Medicine &amp; Pathobiology, University of Toronto and Mount Sinai Hospital, Institute of Health Policy Management and Evaluation Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J.","family":"Stanworth","sequence":"additional","affiliation":[{"name":"NHS Blood &amp; Transplant\/Oxford University Hospitals NHS Trust Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12998"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2872"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2010.02980.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2012.04.009"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.587056"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004310050551"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211801"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.2726"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2010.02.007"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-3-92"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.7.991"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197801000-00001"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002154"},{"key":"e_1_2_7_16_1","first-page":"CD004863","article-title":"Early erythropoietin for preventing red blood cell transfusion in preterm and\/or low birth weight infants","volume":"4","author":"Ohlsson A","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_17_1","first-page":"CD000512","article-title":"Low versus high haemoglobin concentration threshold for blood transfusion for preventing morbidity and mortality in very low birth weight infants","author":"Whyte R","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2012.09180.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2012.04.007"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-0338"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-11-48"},{"key":"e_1_2_7_22_1","first-page":"358","article-title":"Blood transfusion reactions in Malaysian newborn infants","volume":"53","author":"Boo NY","year":"1998","journal-title":"Med J Malaysia"},{"key":"e_1_2_7_23_1","first-page":"30","article-title":"Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria","volume":"9","author":"Ayede AI","year":"2011","journal-title":"Ann Ib Postgrad Med"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199905000-00011"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2000.40121463.x"},{"key":"e_1_2_7_26_1","first-page":"1","article-title":"Evaluation of certain food additives and contaminants. 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