ArticlePediatric research2022
Sex-specific cytokine responses and neurocognitive outcome after blood transfusions in preterm infants.
Article in Pediatric research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 26 citations in OpenAlex.
- Trial
- Red blood cell transfusion is not associated with lymphocyte subpopulation counts in very low birthweight infants.Molecular and cellular pediatrics · 2026Article
- Neonatal phlebotomy-induced anemia compromises mitochondrial bioenergetics in the developing hippocampus.bioRxiv : the preprint server for biology · 2025Article
- 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
- Adverse outcomes after red blood cell transfusion in very low birth weight infants in a resource-restricted hospital.Transfusion · 2025Article
- Stored RBC transfusions leads to the systemic inflammatory response syndrome in anemic murine neonates.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2024Article
- Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants.BMJ paediatrics open · 2024Observational
- Prevention of Inflammatory Disorders in the Preterm Neonate: An Update with a Special Focus on Bronchopulmonary Dysplasia.Neonatology · 2024Review
- Anemia, Iron Supplementation, and the Brain.Clinics in perinatology · 2023Review
- Blood Donor Sex and Outcomes in Transfused Infants.Clinics in perinatology · 2023Review
- Response to Therapeutic Interventions in the NICU: Role of Sex as a Biological Variable.NeoReviews · 2023Article
- New frontiers in neonatal red blood cell transfusion research.Journal of perinatology : official journal of the California Perinatal Association · 2023Review
- Identification and prediction model of placenta-brain axis genes associated with neurodevelopmental delay in moderate and late preterm children.BMC medicine · 2023Article
- The Need to Address Sex as a Biological Variable in Neonatal Clinical Studies.The Journal of pediatrics · 2023Article
- Associations between the human immune system and gut microbiome with neurodevelopment in the first 5 years of life: A systematic scoping review.Developmental psychobiology · 2023Article
- Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children.Children (Basel, Switzerland) · 2023Article
- Red Blood Cell Donor Sex Associated Effects on Morbidity and Mortality in the Extremely Preterm Newborn.Children (Basel, Switzerland) · 2022Review
- Sex Differences in the Association of Pretransfusion Hemoglobin Levels with Brain Structure and Function in the Preterm Infant.The Journal of pediatrics · 2022Article
- Early Biomarkers of Hypoxia and Inflammation and Two-Year Neurodevelopmental Outcomes in the Preterm Erythropoietin Neuroprotection (PENUT) Trial.EBioMedicine · 2021Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThe objective of this study was to determine sex-specific differences in inflammatory cytokine responses to red blood cell (RBC) transfusion in preterm infants in the neonatal period and their relationship to later neurocognitive status.
methodsInfants with a birth weight <1000 g and gestational age 22-29 weeks were enrolled in the Transfusion of Prematures (TOP) trial. The total number of transfusions was used as a marker of transfusion status. Nineteen cytokines and biomarkers were analyzed from 71 infants longitudinally during the neonatal period. Twenty-six infants completed the Bayley Scales of Infant & Toddler Development, 3rd Edition (Bayley-III) at 12 months' corrected age.
resultsNine cytokine levels were significantly elevated in proportion to the number of transfusions received. Of those, one cytokine showed a sex-specific finding (p = 0.004): monocyte chemoattractant protein-1, MCP-1, rose substantially in females (8.9% change per additional transfusion), but not in males (-0.8% change). Higher concentrations of MCP-1 exclusively were associated with worse Bayley-III scores: decreased cognitive raw scores (p = 0.0005) and motor scaled scores (p < 0.0001).
conclusionsThis study provides evidence of a sex-specific difference in the inflammatory response to RBC transfusions during neonatal life, with MCP-1 levels rising only in females and inversely correlating with neurocognitive status at 12 months old. IMPACT: It is important to understand the risk factors for abnormal neurodevelopment in preterm infants, including anemia and RBC transfusion, in order to improve outcomes and provide potential targets for therapy. Our study investigates and provides the first evidence of sex-specific differences in inflammatory cytokine responses to RBC transfusions in preterm infants in the neonatal period, and their relationship to later cognitive outcomes. This study critically suggests that different transfusion thresholds may have a sex-specific effect on neurodevelopment: females have worse cognitive outcomes with increased number of transfusions, while males have worse outcomes with lower number of transfusions.
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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.