Transfusion histories of neonates who developed severe retinopathy of prematurity

Introduction: The recent BORN study suggests the incidence of retinopathy of prematurity (ROP) might be significantly reduced by transfusing extremely low gestational age neonates (ELGANs) with red blood cells (RBCs) from term umbilical cord blood. We are uncertain what proportion of infants with severe ROP had no RBC transfusions and thus would not benefit from changing transfusion practice. Methods: We created detailed transfusion histories of all infants in our health system (2021 – 2024) who developed severe ROP. Results: Severe (stage ≥3) ROP was diagnosed in 34 infants; 32 of these had received 1-18 RBC transfusions. Eleven also received 1-16 platelet transfusions. Two received no transfusions. Conclusion: A small minority of infants with severe ROP were never transfused, thus changing transfusion practice would not likely prevent all cases. However, the great majority had multiple RBC transfusions and thus might benefit from cord blood RBC transfusions.