INSPIRE-study - International Neonatal tranSfusion PoInt pREvalence


Most preterm babies admitted to a Neonatal Intensive Care Unit (NICU) receive blood transfusions. Some neonates, however, receive blood transfusions even though these transfusions may not be necessary, cause side effects or even harm. There are no international guidelines that have been incorporated into clinical practice by Europe as a whole, and there is significant variation in transfusion practice within Europe. Additionally, high quality data on neonatal transfusion practice in Europe is lacking.

Therefore, the International Neonatal tranSfusion PoInt pREvalence study (INSPIRE) aims to describe the current state and indications for blood transfusions among preterm babies in Europe. Another goal of the study is to describe the use of guidelines and variation between different countries.


Description and impact of the INSPIRE-study

Preterm babies with a gestational age of less than 32 weeks at birth who are admitted to a tertiary level NICU are included in the study. Over 60 NICUs from 19 European countries will participate in the study. Study data will be collected over a one-year period, in which each participating NICU will collect data during six weeks.

The study will describe current neonatal transfusion practices within Europe. These results will help to improve practice, develop future clinical studies, and inform guideline writing. Additionally, the results may help to reduce unnecessary transfusions through increased awareness for the proper use of transfusions in this vulnerable patient group.

The Neonatal Transfusion Network (NTN)

The INSPIRE-study is performed by the Neonatal Transfusion Network (NTN), an international, interdisciplinary neonatal transfusion research network. NTN aims to improve current transfusion practices and generate more evidence for neonatal transfusion medicine.

The role of EFCNI

In collaboration with NTN, EFCNI coordinated an international parent advisory board (PAB). This board gave input and feedback on project materials, such as the study protocol. The PAB was chaired by EFCNI and met on a regular basis throughout the duration of the project. Furthermore, EFCNI gave advice and provided input on topics related to ethics and patient information throughout the project.

Parent Adivsory Board (PAB) Meetings

In 2022 and 2023, overall three Parent Advisory Board Meetings for the INSPIRE-study (International Neonatal tranSfusion PoInt pREvalence study) took place. Parent representatives and members from the Neonatal Transfusion Network (NTN) met online to discuss and share experiences regarding neonatal blood transfusions in Europe. The discussion results and parents’ input were used for the development of the study. Furthermore, parents were involved in the  development of the manuscript. Our sincere thanks go to all participants for their valuable contributions.

2nd PAB Meeting on 12 October 2022

International guideline initiative for neonatal transfusion clinical practice recommendations

In 2023, international experts from the Neonatal Transfusion Network (NTN) and from the US virtually came together to discuss current practice and summarise evidence from clinical trials on neonatal red blood cell transfusions. The NTN has formed a Steering Committee to develop clinical practice recommendations for neonatal transfusions. EFCNI together with two parent representatives participated in the meeting to give feedback and input from the patient and parental perspective.

Panel Meeting on 7 June 2023

Links and Downloads

For more information about the INSPIRE-study, please visit the website of NTN:

Note about funding

The INSPIRE-study is funded by the Sanquin Blood Supply Foundation (the Dutch Blood Bank), the European Society for Pediatric Research (ESPR) and the European Blood Alliance (EBA). EFCNI was involved from September 2021 until September 2023.