Enteral erythropoietin increases plasma erythropoietin level in preterm infants: a randomized controlled trial

Area of Science:

• Neonatal Medicine
• Pediatric Hematology
• Pharmacology

Background:

• Preterm infants are at risk for anemia and require interventions to support erythropoiesis.
• Erythropoietin is a key hormone regulating red blood cell production.

Purpose of the Study:

• To assess the impact of enteral recombinant human erythropoietin (rhEPO) on erythropoietin levels and erythropoiesis in preterm infants.
• To evaluate rhEPO's efficacy when administered orally.

Main Methods:

• A randomized controlled trial was conducted in a Level III Neonatal Intensive Care Unit (NICU).
• Sixteen preterm infants (<34 weeks gestation, <1800g birth weight) received either enteral rhEPO plus iron or iron alone.
• Hemoglobin, hematocrit, reticulocyte count, serum erythropoietin, and ferritin were measured at baseline, day 10, and discharge.

Main Results:

• While hemoglobin and hematocrit did not differ between groups at discharge, reticulocyte counts were significantly higher in the rhEPO group (P=0.03).
• Serum erythropoietin levels were also significantly elevated in infants receiving enteral rhEPO (P=0.006).
• Serum ferritin levels were lower in the rhEPO group, though not statistically significant.

Conclusions:

• Enteral administration of rhEPO effectively increases serum erythropoietin and reticulocyte counts in preterm infants.
• This route of rhEPO administration shows potential for stimulating erythropoiesis without significantly impacting major hematological parameters by discharge.