Do transfusions cause NEC? Or is it the anemia?

A prospective multicenter cohort study of 600 VLBW infants studied the effect of RBC transfusions and anemia on the development of necrotizing enterocolitis and mortality. In a multivariable analysis, the rate of NEC was associated with severe anemia, but not with RBC transfusion.

Association of RBC transfusion, anemia and NEC in VLBW infants. Patel et al, 2016.