Is erythropoietin an acceptable treatment modality for routine use in preventing anaemia of prematurity?

Objectives: To find out whether routine use of erythropoietin (EPO) would reduce transfusion requirements in infants <1.5 kg and/or <32 weeks at birth and compare haemoglobin and reticulocyte counts of EPO treated and untreated groups.

Methods: Seventy eight infants were randomized. Cases received subcutaneous EPO 300 units/kg/day,thrice weekly starting before 72 hours of birth for 14 days. All infants were given oral iron and folic acid with initiation of enteral feedings and this was continued during the entire treatment period.

Results: EPO treated group acquired high reticulocyte counts earlier than control group with maximal difference in 2nd week but there was no statistically significant difference between groups. There was a gradual decline in haemoglobin values in both cases and controls; though this was less marked in the EPO treated group, the difference was not statistically significant. There was no statistically significant difference in total transfusion requirements between infants who received EPO and the control group.

Conclusion: There is no benefit from routine use of EPO during the first two weeks of life in preventing anaemia of prematurity.

(Key words:  Erythropoietin; EPO; anaemia of prematurity; haemoglobin; reticulocyte count)

DOI: http://dx.doi.org/10.4038/sljch.v40i4.3841

Sri Lanka Journal of Child Health, 2011; 40(4): 159-163