{"id":9432,"date":"2026-06-09T16:03:39","date_gmt":"2026-06-09T14:03:39","guid":{"rendered":"https:\/\/fhu-premimpact.org\/?post_type=publication&#038;p=9432"},"modified":"2026-07-03T16:06:48","modified_gmt":"2026-07-03T14:06:48","slug":"school-age-neurodevelopmental-outcomes-after-non-emergency-red-blood-cell-transfusions-in-preterm-infants-a-propensity-score-matched-study-from-the-epipage-2-cohort","status":"publish","type":"publication","link":"https:\/\/fhu-premimpact.org\/en\/publications\/school-age-neurodevelopmental-outcomes-after-non-emergency-red-blood-cell-transfusions-in-preterm-infants-a-propensity-score-matched-study-from-the-epipage-2-cohort\/","title":{"rendered":"School-age neurodevelopmental outcomes after non-emergency red blood cell transfusions in preterm infants: a propensity score-matched study from the Epipage 2 cohort"},"content":{"rendered":"\n<h3 class=\"wp-block-heading\">Abstract<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The objective of this study is to evaluate whether non-emergency red blood cell transfusions (RBCT) is associated with neurologic outcomes in preterm infants born at 27-31 weeks of gestation. This analysis used data from the Etude Epid\u00e9miologique sur les Petits Ages Gestationnels (EPIPAGE-2), a French nationwide prospective cohort. Infants born at 27-31 weeks and surviving to 5\u00bd years were included, excluding those with emergency RBCT indications. Neurologic outcomes, defined as moderate or severe disabilities, a composite of motor, neurosensory, and cognitive disabilities, were assessed at 5\u00bd years with standardized scales. Behavioral difficulties were evaluated using parental questionnaires. Transfused and non-transfused infants were matched 1:1 using propensity scores. Statistical analyses included odds ratios (ORs) and mean differences. Of the 2182 infants included (656 transfused, 1526 non-transfused), 1062 were matched (531 per group). In the unmatched cohort, RBCT exposure was significantly associated with the composite outcome of moderate to severe neurological disabilities (OR, 1.40; 95%CI, 1.04-1.87). Cognitive impairment and developmental coordination disorders were significantly increased with RBCT (OR, 1.40; 95%CI, 1.07-1.81 and OR, 1.44; 95%CI, 1.06-1.96), respectively. After adjustment using the propensity score, RBCTs were not significantly associated with any individual outcome: cerebral palsy, overall cognitive deficiency, coordination disorders, behavioral difficulties, or moderate-to-severe neurological disabilities. Only the association with cognitive performance relating to working memory persisted (mean difference, &#8211; 2.3; 95%CI, &#8211; 4.2 to &#8211; 0.5).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> After controlling for potential confounders, non-emergency RBCTs in preterm infants born at 27-31 weeks were not significantly associated with long-term neurologic outcomes but reduced working memory warrants further investigation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Trial registration:<\/strong> <a href=\"http:\/\/clinicaltrials.gov\/show\/NCT03078439\">NCT03078439<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What is known:<\/strong> \u2022 Red blood cell transfusions (RBCTs) are frequently administered to preterm infants and have been associated with adverse neonatal outcomes in observational studies. \u2022 The long-term neurodevelopmental consequences of RBCT exposure remain uncertain because transfused infants are generally sicker and more immature, making confounding difficult to address.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What is new:<\/strong> \u2022 In a large nationwide cohort of preterm infants born at 27-31 weeks&#8217; gestation, non-emergency RBCT exposure was associated with poorer neurodevelopmental outcomes in unadjusted analyses but not after propensity score matching.A modest reduction in working memory performance persisted after adjustment, suggesting a potential domain-specific effect that warrants further investigation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> Disabilities; Infants; Red blood cell transfusion; neurological outcome.<\/p>\n","protected":false},"excerpt":{"rendered":"<p> Eur J Pediatr . 2026 Jun 9;185(7):482<\/p>\n","protected":false},"featured_media":0,"template":"","class_list":["post-9432","publication","type-publication","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - 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