Related Experiment Video
Updated: May 19, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Decrease in incidence of bronchopulmonary dysplasia with erythropoietin administration in preterm infants: a
Niti Rayjada1, Lorayne Barton, Linda S Chan
1Center for Fetal and Neonatal Medicine and USC Division of Neonatal Medicine, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Insights
Erythropoietin (EPO) treatment for anemia of prematurity (AOP) in premature infants was associated with a lower incidence of bronchopulmonary dysplasia (BPD). Early EPO initiation, within 4 weeks, showed the most significant reduction in BPD rates.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Pharmacology
Background:
- Bronchopulmonary dysplasia (BPD) remains a significant concern in premature infants despite clinical advances.
- Erythropoietin (EPO) is used for anemia of prematurity (AOP) and has shown potential for lung repair in animal models.
Purpose of the Study:
- To investigate the association between EPO treatment for AOP and the incidence of BPD in premature infants.
Main Methods:
- Retrospective study of neonates (500–1500g birth weight, 22–32 weeks GA) admitted between 1994-2002.
- Comparison of BPD incidence and morbidities between infants who received EPO and those who did not.
Main Results:
- A lower incidence of BPD was observed in infants receiving EPO (26%) compared to those who did not (36%, p=0.03).
- Adjusted analysis showed an odds ratio of 0.50 for BPD with EPO treatment (p=0.0028).
- BPD rates were significantly lower when EPO was initiated before 4 weeks of age (16%) versus later initiation (44%).
Conclusions:
- EPO treatment is associated with a reduced incidence of BPD in preterm infants.
- Early initiation of EPO treatment (within 4 weeks of life) is particularly effective in lowering BPD rates.
Background:
Despite advances in clinical care, the incidence of bronchopulmonary dysplasia (BPD) remains high in premature infants. Erythropoietin (EPO) is used for the treatment of anemia of prematurity (AOP) to decrease blood transfusion needs. EPO has been shown to mobilize circulating endothelial progenitor cells and to enhance lung repair in animal models.
Objective:
To determine whether EPO treatment for AOP was associated with a reduced incidence of BPD in premature infants.
Methods:
This retrospective study was performed on all live-born neonates with birth weights from 500 to 1,500 g and gestational age (GA) from 22 to 32 weeks admitted from 1994 to 2002. Infants who received EPO and those who did not receive EPO were compared for incidence of BPD and other morbidities.
Results:
Of 478 patients, 297 received EPO before 36 weeks' postmenstrual age (group 1) and 181 did not receive EPO (group 2). Group 1 was of similar birth weight but lower GA than group 2. The incidence of BPD was lower in group 1 than group 2 (26 vs. 36%, p = 0.03); after adjusting for significant risk factors, the adjusted odds ratio for BPD was 0.50 (95% CI 0.32, 0.79), p = 0.0028. The BPD rate was much lower when EPO was initiated before 4 weeks of age (16%) as compared to later initiation (44%).
Conclusions:
This study shows an association between EPO treatment and reduced incidence of BPD in preterm infants, particularly when EPO treatment was initiated within the first 4 weeks of life.
Related Concept Videos
01:24Factors Affecting Erythropoiesis
Several factors influence the erythrocyte production rate, with tissue oxygen level being among the most critical. Intense exercise or high altitudes can cause tissue hypoxia, which triggers the kidneys to release more erythropoietin (EPO) into the bloodstream.
EPO then...
01:14Erythropoiesis