Anemia and transfusion practices in the neonatal period, especially among preterm infants, represent a critical intersection in modern perinatal medicine. Neonates, particularly those born prematurely, frequently require red blood cell transfusions to manage anemia from iatrogenic blood loss, immature hematopoiesis, or critical illness. Despite being a cornerstone of neonatal care, anemia and transfusion interventions can modulate immune function and inflammatory pathways, potentially exacerbating morbidities such as necrotizing enterocolitis (NEC), systemic inflammatory response syndrome (SIRS), and organ dysfunction. Recent research has begun to uncover the complex interplay among transfusion product characteristics, recipient immune phenotype, and post-transfusion outcomes, but key knowledge gaps remain regarding underlying mechanisms, predictive biomarkers, and optimal management strategies.

This Research Topic aims to advance understanding of how neonatal anemia and transfusion practices affect immune activation and inflammation, elucidate the underlying mechanisms, and identify biomarkers that can inform individualized patient care. We encourage research that examines the links among anemia-induced tissue hypoxia, immune system priming, and the heightened vulnerability of the neonatal period to inflammatory injury. Mechanistic studies of transfusion-associated immune modulation, including the roles of storage lesions, donor variability, and red cell processing, are especially welcome. Another objective is to highlight clinically actionable insights, such as risk-stratification tools, monitoring strategies, and novel therapeutic targets, to improve the safety and efficacy of transfusion practices in neonatal intensive care units.

To gather further insights into this evolving field of neonatal hematology and immunology, we welcome articles addressing, but not limited to, the following themes:

• Mechanistic investigations into the relationship between anemia, hypoxia, and immune activation in neonates
• Impact of transfusion product characteristics on inflammatory and immune responses
• Biomarker discovery through multi-omics, cellular, and molecular profiling to stratify inflammation risk
• Immune cell activation pathways, including monocyte/neutrophil dynamics, TLR/TREM signaling, and platelet–immune interactions post-transfusion
• Clinical studies on transfusion thresholds, storage age of blood, and outcomes, including NEC, SIRS, and organ injury
• Translational and preclinical models bridging murine and human neonatal immunity
• Predictive models and individualized approaches for transfusion management in NICUs

We welcome original research articles, reviews, brief research reports, case studies, and protocols that address these themes.

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Neonatal Anemia, Transfusion Practices, and Inflammation: Mechanisms, Biomarkers, and Clinical Implications