Efficacy of erythropoietin in premature infants

OBJECTIVE: To identify the effect of early parental recombinant human erythropoietin and iron administration on the blood transfusion requirement of premature infants.

METHODS: In a controlled clinical trial conducted at the neonatal intensive care unit of Al-Hada Military Hospital, Taif, Kingdom of Saudi Arabia over a 16 months period, we assigned 20 very low birth weight infants with gestational age of (mean ± standard error of mean) 28.4 ± 0.5 weeks and birth weight of (mean ± standard error of mean) 1031 ± 42 gm, to receive either intravenous recombinant human erythropoietin 200 U/kg/day and iron 1mg/kg/day or conventional therapy over a 21 day study period. Blood transfusion administration undergoes a strict protocol in our nursery.

RESULTS: During the 3 week study period, the hemoglobin and hematocrit remained similar in the 2 groups while the reticulocyte counts were greater in the recombinant human erythropoietin recipients on day 14. The number and volume of blood transfusions were similar in both groups.

CONCLUSION: Very low birth weight infants receive fewer blood transfusions than the number previously reported. Strict phlebotomy and transfusion criteria could minimize the need for human recombinant erythropoietin.