Darbepoetin and Infantile Hemangioma in Premature Infants

Objectives: An association between erythropoietin (Epo) administration and infantile hemangiomas (IH) in preterm infants was previously described; however, scarce data exists on a newer drug, darbepoetin (Darbe) and IH. We aimed to determine whether Darbe treatment was associated with IH in our preterm population. Methods: Retrospective observational cohort study including a consecutive sample of premature babies born < 32 weeks at a single tertiary center between the years 2012-2023. We compared the rate of IH with Epo exposure, Darbe exposure and no exposure. Results: The cohort comprised 390 infants: 262 infants with no exposure, 36 infants with Epo exposure, and 92 infants with Darbe exposure. Exposed infants had significantly lower birth weight and gestational age compared to non-exposed infants. No differences were found in gestational age or birth weight between the two drug exposure groups. The rate of IH was 6.8%, 8.3% and 18.4% in the no exposure, Epo exposure and Darbe exposure groups, respectively. The rate of IH in the Darbe group was significantly higher compared to the non-exposed group (p = 0.003), and Darbe exposure was found to be significantly correlated with IH in a multiple logistic regression model (OR 3.07, 95% CI 1.5-6.2; p = 0.002). However, after adjusting for gestational age or birth weight, this correlation was no longer significant. Conclusions: Darbe exposure was associated with a higher rate of IH than no exposure in this cohort, but the association did not persist after adjustment for maturity, and the design does not allow us to distinguish the effect of Darbe from the effect of prematurity itself. Further prospective studies are needed to ascertain these findings.