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[Prophylaxis of anemia of prematurity with erythropoietin. Case control study]
M de la Torre Aguilar1, F J Gascón Jiménez, M Zapatero Martínez
1Departamento de Pediatría. Unidad de Neonatología. Hospital Universitario Reina Sofía.
Insights
Recombinant human erythropoietin (rH-EPO) effectively reduced blood transfusions in premature infants. This treatment was most beneficial for stable newborns weighing over 1000 grams.
Area of Science:
- Neonatal Medicine
- Hematology
Context:
- Anemia of prematurity is a common complication in very low birth weight infants.
- Prophylactic interventions are crucial to minimize transfusion-related risks.
Purpose:
- To assess the efficacy of prophylactic recombinant human erythropoietin (rH-EPO) in managing anemia of prematurity.
- To determine the impact of rH-EPO on transfusion requirements in premature neonates.
Summary:
- A retrospective case-control study involving 108 premature infants (<1500g, <34 weeks gestation) compared rH-EPO treatment with standard care.
- rH-EPO treated infants (n=54) received 250 U/kg subcutaneously thrice weekly for 6 weeks, alongside iron and multivitamins.
- The rH-EPO group showed significantly fewer transfusions per patient (0.69 vs 1.46) and a higher proportion avoiding transfusions (63% vs 29.7%).
Impact:
- Prophylactic rH-EPO significantly reduces the need for blood transfusions in premature infants.
- The benefit is particularly noted in stable neonates with birth weights exceeding 1000 grams.
- This finding supports the use of rH-EPO as a prophylactic strategy to improve outcomes in preterm infants.
Aim:
To evaluate the effectiveness of recombinant human erythropoietin (rH-EPO) in the prophylactic treatment of anemia of prematurity.
Patients And Methods:
We performed a non-randomised, retrospective case control study of 108 premature babies with birth weights of less than 1500 grams and gestational age of less than 34 weeks. Infants with hemolytic or hemorrhagic disease and those who died in the first days of life were excluded. Fifty-four patients were treated with rH-EPO (250 U/kg subcutaneously, 3 times a week) for 6 weeks. A ferrous sulfate supplement was also administered orally (4-6 mg/kg/day) with a multivitamin complex.
Results:
There were no differences between groups in gestational age, birth weight, ferritin levels, hematocrit and hemoglobin on admission, amount of blood sampled and days with ventilatory support. The number of transfusions per patient were 1.46 +/- 1.38 in control group versus 0.69 +/- 1.19 in rH-EPO-treated infants (p < 0.002). Sixty-three percent of infants in the treated group did not require blood transfusions compared with only 29.7% in the nontreated group (p < 0.001). The lowest mean hemoglobin was 8.72 +/- 2.62 gr/dl in the control group versus 9.70 +/- 2.08 gr/dl in the rH-EPO group.
Conclusions:
Prophylactic treatment with rH-EPO was effective in reducing the number of transfusions, mainly in stable newborn infants with a birth weight greater than 1000 grams.
