# Exploring the Relationship Between Blood Transfusions and Development of Bronchopulmonary Dysplasia in Neonates

## TL;DR

This study found that blood transfusions in preterm infants are strongly linked to the development of a serious lung condition called bronchopulmonary dysplasia.

## Contribution

The study is one of the first to show a strong statistical link between blood transfusions and bronchopulmonary dysplasia in preterm neonates.

## Key findings

- Neonates who received blood transfusions were significantly more likely to develop bronchopulmonary dysplasia (BPD).
- Fresh frozen plasma transfusions were associated with the highest risk of BPD.
- Blood transfusion remained a significant predictor of BPD even after adjusting for other factors.

## Abstract

Background: Transfusions of red blood cells and platelets may worsen pulmonary inflammation and contribute to the development of bronchopulmonary dysplasia (BPD), a common lung condition in preterm infants. Although nearly all infants with severe BPD have received transfusions, their role as a potential cause of BPD has not been thoroughly studied.

Objectives: This study aimed to explore the relationship between blood product transfusions and the development of BPD among preterm neonates in the Department of Neonatology at King Fahad Medical City, Riyadh, Saudi Arabia.

Methods: A retrospective study was conducted from 2011 to 2020 on neonates with a gestational age of less than 32 weeks who were admitted to the hospital within 48 hours of birth. Data were extracted from the department's medical records on patient demographics, clinical factors, and blood transfusions. Logistic regression analysis was performed to assess the relationship between blood transfusion and the development of BPD in the study cohort.

Results: A total of 1,553 neonates were included in the study. The mean gestational age was 28.8 ± 2.7 weeks, and the mean birth weight was 1264.2 ± 515.1 grams. Among the neonates, 183 (11.8%) were diagnosed with BPD. Neonates who received blood transfusions had a significantly higher likelihood of developing BPD compared to those who did not (OR = 9.1, 95% CI = 6.3-13.1), with the risk being even higher among those who received fresh frozen plasma (OR = 9.9). After adjusting for potential confounders, multivariate logistic regression analysis confirmed that blood transfusion remained a significant factor in the development of BPD (OR = 3.8, 95% CI = 2.5-5.8). Stepwise regression analysis further identified blood transfusion as the strongest predictor of BPD (OR = 4.5, 95% CI = 2.91-6.70). Additional significant predictors included retinopathy of prematurity (ROP), patent ductus arteriosus (PDA), sepsis, and non-invasive ventilation (NIV).

Conclusion: This study found a significant association between blood transfusions and the development of BPD in preterm neonates, and it was found as a strong predictor. Other factors such as ROP, PDA, sepsis, and NIV use were also associated with BPD. The findings suggest that blood transfusion may play a critical role in the development of BPD.