ArticlePediatric research2025
Hemoglobin-oxygen affinity changes in neonatal blood transfusions: RBC selection insights.
Article in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- The specifications of blood components for neonatal transfusion: a European study and critical review.Pediatric research · 2026Article
- Association of Day-1 Hemoglobin Oxygen Affinity (p50) with Severe Intraventricular Hemorrhage in Preterm Infants.Indian pediatrics · 2026Article
- Postnatal Changes in Fetal Hemoglobin and Tissue Oxygenation in Preterm and Term Neonates: A Prospective Observational Study.Neonatology · 2026Article
- Elevated day-2 hemoglobin P₅₀ and risk of necrotizing enterocolitis in preterm infants: a pilot study.Pediatric surgery international · 2025Article
- Red blood cell transfusion frequency and the risk and severity of bronchopulmonary dysplasia in preterm infants: a retrospective cohort study.BMC pediatrics · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundDespite preterm newborns often requiring blood transfusions, we have an incomplete understanding of the impact of adult packed red blood cell (pRBC) transfusions on fetal red blood cell (RBC) oxygen affinity. We investigated the influence of adult pRBC on oxygen binding in fetal RBCs obtained from the umbilical cord of preterm newborns. This included exploring the influence of the biological age of adult pRBCs on the oxygen affinity of fetal blood.
methodsCord blood samples from preterm infants were titrated with young (Y-RBC) and old (O-RBC) adult pRBCs using an in vitro transfusion model. Parameters, including oxygen affinity (p50), hemoglobin variants, and red blood cell indices, were measured.
resultsThe titration of cord blood with adult pRBCs (n = 19) resulted in a concentration-dependent decrease in p50, indicating an increased oxygen affinity. Hemoglobin variant analysis revealed a shift in composition, with a decrease in fetal hemoglobin (HbF) and an increase in adult hemoglobin (HbA) following titration.
conclusionThe impact of biological age was evident, as O-RBCs had a more pronounced effect on p50 values compared to Y-RBCs. Understanding the physiologic implications of transfusing preterm infants with adult pRBCs is important for optimizing transfusion practices in newborns. IMPACT: In an in vitro model, titrating adult pRBC into fetal blood significantly affects oxygen binding Oxygen affinity of fetal blood is significantly increased after titration of adult pRBC. Compared to older RBC subpopulations of adult pRBC, oxygen-binding properties of younger RBC subpopulations of adult pRBC more closely approximate the oxygen affinity of fetal blood. This work highlights the importance of investigating the influence of adult pRBC transfusion on fetal RBC oxygen binding. This may have implications for morbidities in the newborn period related to oxygen physiology.
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