Trial reportArchives of pediatrics & adolescent medicine2011
Long-term outcome of brain structure in premature infants: effects of liberal vs restricted red blood cell transfusions.
Trial report in Archives of pediatrics & adolescent medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 122 citations in OpenAlex.
- Anemia and Red Blood Cell Transfusions, Cerebral Oxygenation, Brain Injury and Development, and Neurodevelopmental Outcome in Preterm Infants: A Systematic Review.Frontiers in pediatrics · 2021Pooled it
- Restrictive versus liberal transfusion thresholds in very low birth weight infants: A systematic review with meta-analysis.PloS one · 2021Pooled it
- Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trials with meta-analysis and trial sequential analysis.BMJ (Clinical research ed.) · 2015Pooled it
- Trial
- Tissue Oxygenation Changes After Transfusion and Outcomes in Preterm Infants: A Secondary Near-Infrared Spectroscopy Study of the Transfusion of Prematures Randomized Clinical Trial (TOP NIRS).JAMA network open · 2023Trial
- Long-term outcome of brain structure in female preterm infants: possible associations of liberal versus restrictive red blood cell transfusions.The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2021Trial
- Higher or Lower Hemoglobin Transfusion Thresholds for Preterm Infants.The New England journal of medicine · 2020Trial
- Cognitive outcomes of preterm infants randomized to darbepoetin, erythropoietin, or placebo.Pediatrics · 2014Trial
- A randomized, masked, placebo-controlled study of darbepoetin alfa in preterm infants.Pediatrics · 2013Trial
- A randomized, masked study of weekly erythropoietin dosing in preterm infants.The Journal of pediatrics · 2012Trial
- Safety and tolerability of amustaline/glutathione pathogen-reduced red blood cells in neonatal rats.Transfusion · 2026Article
- Association of blood component transfusions with neurodevelopmental impairment in preterm infants by gestational age.Pediatric research · 2026Article
- School-age neurodevelopmental outcomes after non-emergency red blood cell transfusions in preterm infants: a propensity score-matched study from the Epipage 2 cohort.European journal of pediatrics · 2026Observational
- Impact of red blood cell transfusion and transfusion strategies on clinical outcomes in extremely low gestational age neonates.Frontiers in pediatrics · 2026Article
- Biological sex and transfusion practices in the NICU.Pediatric research · 2025Article
- The transfusion of prematures early school age follow-up (TOP 5): protocol for a longitudinal cohort study.BMC pediatrics · 2025Article
- Fetal Hemoglobin as a Predictive Biomarker for Retinopathy of Prematurity: A Prospective Multicenter Cohort Study in Portugal.Biomedicines · 2025Article
- Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants.BMJ paediatrics open · 2024Observational
- Identification of Genes Responding to Iron or Choline Treatment for Early-Life Iron Deficiency in the Male Rat Hippocampal Transcriptomes.The Journal of nutrition · 2024Article
- Impact of Same Red Blood Cell Infusion at Different Intervals on Premature Infants' Hemoglobin Levels.International journal of general medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo assess the long-term outcome of brain structure in preterm infants, at an average age of 12 years, who received a red blood cell transfusion for anemia of prematurity.
designAs neonates, this cohort of infants participated in a clinical trial in which they received red blood cell transfusions based on a high pretransfusion hematocrit threshold (liberal group) or a low hematocrit threshold (restricted group). These 2 preterm groups were compared with a group of full-term healthy control children.
settingTertiary care hospital.
participantsMagnetic resonance imaging scans for 44 of the original 100 subjects were obtained.
interventionLiberal vs restricted transfusion.
main outcome measuresIntracranial volume, total brain tissue, total cerebrospinal fluid, cerebral cortex and cerebral white matter volume, subcortical nuclei volume, and cerebellum volume.
resultsIntracranial volume was substantially smaller in the liberal group compared with controls. Intracranial volume in the restricted group was not different from controls. Whole-cortex volume was not different in either preterm group compared with controls. Cerebral white matter was substantially reduced in both preterm groups, more so for the liberal group. The subcortical nuclei were substantially decreased in volume, equally so for both preterm groups compared with controls. When sex effects were evaluated, the girls in the liberal group had the most significant abnormalities.
conclusionRed blood cell transfusions affected the long-term outcome of premature infants as indicated by reduced brain volumes at 12 years of age for neonates who received transfusions using liberal guidelines.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.