Mechanisms Affecting the Gut of Preterm Infants (MAGPIE-2) study
Research type
Research Study
Full title
Mechanisms Affecting the Gut of Preterm Infants receiving blood transfusion with different feed interventions-2 (MAGPIE-2)
IRAS ID
347694
Contact name
Jayanta Banerjee
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
In the United Kingdom each year about 7000 babies are born very preterm and need specialist neonatal care. Necrotising enterocolitis (NEC) is a serious gut condition affecting 1 out of 10 extremely preterm babies (those who are born before 28 completed weeks of pregnancy). Babies with NEC commonly require surgery and, of these, one out of three unfortunately will not survive. About half of NEC survivors have long-term neurodevelopmental problems like cerebral palsy or learning difficulties.
Risk factors for NEC include prematurity, reduced fetal growth, multiple antibiotic courses after birth, formula milk feeding, blood infection, and anaemia and blood transfusion. Although our understanding of the underlying process leading to NEC remains incomplete, research indicates that changes in blood flow to the gut, reducing gut tissue oxygen levels, weakening defence mechanisms, and making the gut wall more vulnerable to injury all play a role in developing NEC. Two routine neonatal interventions have been shown to alter gut blood flow and tissue oxygen levels: milk feeding and blood transfusion. Furthermore, there is a well described link between blood transfusion and NEC; the WithHolding Enteral feeds Around Transfusion (WHEAT) Trial is an ongoing randomised international trial comparing the effect of pausing and continuing feeds when a baby gets a blood transfusion, to see if pausing feeds during blood transfusion prevents NEC. Researchers believe feeding and blood transfusion may lead to reduced blood flow and relative ischaemia of the gut tissue resulting in NEC, but this mechanism remains unproven. In this MAGPIE-2 study we will examine the proposed mechanisms leading to development of NEC using some additional measurements performed non-invasively, such as brain and gut tissue oxygen levels and ultrasound scan of the gut blood flow around blood transfusion.
REC name
London - Bloomsbury Research Ethics Committee
REC reference
25/LO/0688
Date of REC Opinion
3 Nov 2025
REC opinion
Further Information Favourable Opinion