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Effect of enteral erythropoietin on feeding-related complications in preterm newborns: A pilot randomized controlled
Omneya M Omar1, Mohamed N Massoud1, Hesham Ghazal1
1Department of Paediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Insights
Enteral recombinant human erythropoietin (rhEPO) did not significantly impact feeding intolerance or necrotizing enterocolitis (NEC) in preterm infants. This pilot study suggests rhEPO is not effective for improving feeding outcomes in this vulnerable population.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Pharmacology
Background:
- Preterm infants often experience feeding-related complications.
- Recombinant human erythropoietin (rhEPO) is explored for potential benefits in neonates.
- Enteral administration of rhEPO is a novel approach to investigate.
Purpose of the Study:
- To assess the efficacy of enteral rhEPO in reducing feeding complications in preterm infants.
- To evaluate the impact of rhEPO on feeding intolerance and necrotizing enterocolitis (NEC).
Main Methods:
- A double-blind, randomized controlled pilot study.
- 120 preterm infants (≤ 32 weeks gestation) were enrolled.
- Infants received either enteral rhEPO or placebo; outcomes included time to full enteral feeding, feeding intolerance, and NEC incidence.
Main Results:
- No significant differences were observed between the rhEPO and placebo groups in achieving full enteral feeding.
- The incidence of feeding intolerance and necrotizing enterocolitis (NEC) did not differ between groups.
- The study found no statistically significant benefits of enteral rhEPO on feeding outcomes.
Conclusions:
- Enteral administration of recombinant human erythropoietin does not appear to improve feeding tolerance in preterm infants.
- rhEPO did not demonstrate a reduction in the incidence of necrotizing enterocolitis (NEC).
- Further research may be needed to explore alternative rhEPO administration routes or different therapeutic targets.
Background And Study Aims:
To evaluate the effects of enteral administration of recombinant human erythropoietin (rhEPO) on feeding-related complications in preterm infants.
Patients And Methods:
This double-blind, randomized controlled pilot study enrolled 120 preterm infants born ≤ 32 weeks' gestation who were admitted to the neonatal intensive care unit in a tertiary hospital; 60 patients randomly received recombinant human erythropoietin while the other 60 received placebo. Newborns who underwent cardiopulmonary resuscitation, infants with genetic syndromes, infants with inborn errors of metabolism, infants with major congenital or acquired gastrointestinal tract malformations, infants with previous use of parenteral growth factors such as recombinant human erythropoietin and granulocyte-macrophage colony-stimuating factor (GM-CSF) and infants previously treated with intravenous immunoglobulin were excluded. Overall, 48 patients withdrew from the study because of intravenous haematopoietic growth factor intake or death before treatment was completed. A total of 72 preterm infants remained in the study: 36 preterm infants in the erythropoietin (EPO) group, and 36 preterm infants in the placebo group. The day that enteral feeding was successfully started, the time to establishing one-half, two-thirds, and full enteral feedings (reaching at least 150 mL/kg/day), the number of episodes of feeding intolerance, the time to regain birth weight and the incidence of necrotizing enterocolitis (NEC) were recorded.
Results:
Both groups showed no significant difference in the time to achieve one-half, two-thirds, or full enteral feeding, no signs of feeding intolerance, and no cases of NEC were recorded.
Conclusion:
Enteral erythropoietin does not appear to affect feeding intolerance or NEC incidence.
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