Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)

1990-472X

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

11594

10.18499/1990-472X-2026-27-1-%p

Systemic modeling of cause-and-effect relationships between transfusion therapy and retinal vasculopathy in premature infants

Polikarpova

Irina

PhD, Associate Professor of the Department of Pediatrics No. 1neonat.yagma@mail.ru

Federal State Budgetary Educational Institution of Higher Medical Education of the Ministry of Health of Russia

06042026

271

03042026

2026

Aim. To analyze the association between the number of blood transfusions and the development of severe stages of retinopathy of prematurity (ROP) and to propose a holistic pathogenetic model based on P.K. Anokhin's theory of functional systems. Materials and methods. A retrospective analysis of 92 newborns with very low and extremely low birth weight (1500 g, gestational age 29 weeks) who received one or more transfusions of red blood cell-containing components was performed. The relationship between the number of transfusions and the maximum stage of ROP (ICROP classification) and the need for laser photocoagulation was assessed. Statistical analysis was performed using Student's t-test, ANOVA, test (IBM SPSS Statistics 26). Results. A statistically significant direct association was found between the number of blood transfusions and the severity of ROP. The mean number of transfusions in stage 3 ROP was 3.83 compared to 1.63 in stage 1 (p0.001). Among children who underwent laser photocoagulation, 56.7% received 4 transfusions, compared to 25.5% in the group without intervention (p0.001). All cases of aggressive posterior ROP were recorded in children with extremely low birth weight who received multiple transfusions. Conclusion. Low gestational age and extremely low birth weight remain basic risk factors for ROP. Multiple blood transfusions act as a key iatrogenic factor contributing to disease progression. Within the framework of the theory of functional systems, transfusions are considered as an intervention leading to destabilization of the immature oxygenation system and the formation of a pathological system with abnormal angiogenesis. Based on the model, principles of personalized transfusion strategy and holistic homeostasis support are proposed.

retinopathy of prematurity, blood transfusion, preterm infant, theory of functional systems, oxidative stress, systemic approach.

ретинопатия недоношенных, гемотрансфузия, недоношенный ребенок, теория функциональных систем, оксидативный стресс, системный подход.

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