Transfusion Support in Neonates at a University Hospital in Uruguay: a Two-year Retrospective Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction A neonate is an infant from birth to 28 days of life. Preterm and very low birth weight neonates frequently require transfusion support due to physiological immaturity and severe underlying clinical conditions. Neonatal transfusion practice involves specific characteristics such as small-volume transfusions, pediatric aliquots, and specially processed blood components, with thresholds tailored to gestational age, birth weight, and clinical status all of which are observed when determining transfusion management at the Hospital de Clínicas. Objectives To characterize transfusion support among neonates admitted to the Neonatology Unit of Hospital de Clínicas, Uruguay, during 2024–2025, including transfusion practices, clinical characteristics, indications, adverse reactions and outcomes. Materials and methods A retrospective, descriptive, observational study included neonates who received at least one blood component between January 2024 and December 2025. Demographic and clinical characteristics, indications, blood components, adverse reactions and outcomes were analyzed using electronic clinical and transfusion records. Variables were expressed as absolute and relative frequencies and compared between years. Results Among 1,267 live births (646 in 2024; 621 in 2025), 21 neonates required transfusion support: 9 (1.4%) in 2024 and 12 (1.9%) in 2025. In 2024, mean gestational age was 27.9 weeks (range 23–32) and mean birth weight 1,025 g (590–1,470); in 2025, 28.7 weeks (23+1–34+6) and 1,426 g (500–3,625), respectively. Thirty transfusion episodes were recorded in 2024, mean 3.3 per patient (range 1–8), versus 37 in 2025, mean 3.1 (1–8). Plasma-depleted red blood cells were most frequently used (8/9 patients in 2024; 10/12 in 2025), followed by platelets (4/9; 5/12), fresh frozen plasma (1/9; 2/12) and cryoprecipitate (1/9; 1/12). In extremely preterm and very-low-birth-weight infants transfused for anemia, pre-transfusion hemoglobin predominantly ranged from 7–8 g/dL. Platelets were indicated for severe thrombocytopenia (<20,000/mm³) or moderate thrombocytopenia with risk factors, clinical instability or bleeding. Thresholds and practices were assessed according to the NHS Transfusion Policy for Neonates and Children (2014). No transfusion-related adverse events were recorded, although underdiagnosis or underreporting cannot be excluded. Discussion Transfusion support was associated with lower gestational age, lower birth weight and greater clinical severity. The higher proportion transfused in 2025 may reflect differences in patient complexity. The absence of reported reactions highlights the need to strengthen neonatal hemovigilance. Conclusion Neonatal transfusion support was associated with prematurity, very low birth weight and severe illness. Adherence to international recommendations supports current practice while reinforcing individualized decision-making. These findings provide real-world evidence from a Latin American tertiary center and highlight hemovigilance as a key component of transfusion quality and safety.
Institution: Hospital de Clínicas
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223156698