Abstract
BackgroundPreterm infants are at risk for neurodevelopmental sequelae even in absence of major cerebral lesions. The hypothesis that Human Recombinant Erythropoietin (rEpo) could improve the neurodevelopmental outcome in risk neonates has raised the highest interest in recent years.MethodsA group of preterm neonates born at a gestational age ≤ 30 weeks and free from major cerebral lesions or major visual impairment, were included in the study if they had a complete neurologic evaluation for at least 24 months of postmenstrual age. They were assigned to group I in the case they had been treated with rEpo or group II if untreated. The aim was to evaluate whether rEpo, given at the high cumulative doses utilized for hematologic purposes, is able to improve the neurodevelopmental outcome in preterm infants born at a gestational age ≤ 30 weeks. A group of 104 preterm neonates were studied: 59 neonates who received rEpo for 6.9 ± 2.4 weeks at a median cumulative dose of 6300 UI/Kg (6337 ± 2434 UI/Kg), starting at a median age of 4 days and 45 neonates who were born in the period preceding the routine use of rEpo. The neurodevelopmental quotient at 24 month postmenstrual age was assessed utilizing the Griffiths’ Mental Developmental Scales.ResultsOur results failed to show any difference in the Developmental Quotient at 24 month. Bronchopulmonary dysplasia, minor intraventricular hemorrhages and blood transfusions were the clinical features significantly related to the Developmental Quotient.ConclusionsOur results do not support the hypothesis that rEpo, administered with the schedule utilized for hematologic purposes, improve the neurodevelopmental outcome of preterm neonates, at least those preterm infants free from major impairments.
Highlights
Preterm infants are at risk for neurodevelopmental sequelae even in absence of major cerebral lesions
The aim of the present study is to evaluate whether Recombinant Erythropoietin (rEpo), given at the high cumulative doses utilized for Luciano et al Italian Journal of Pediatrics (2015) 41:64 hematologic purposes, has improved the ND outcome in a series of preterm neonates free from major cerebral lesions or major visual impairment compared with a series of untreated neonates born at similar GA
Our results failed to show any difference in developmental quotient (DQ) at 24 month PMA between preterm neonates treated or not treated with rEpo given at doses commonly administered for preventing the anaemia of prematurity, whereas we found a significant lower DQ in neonates affected by minor IVH or BPD and in neonates who required blood transfusions
Summary
Preterm infants are at risk for neurodevelopmental sequelae even in absence of major cerebral lesions. The hypothesis that Human Recombinant Erythropoietin (rEpo) could improve the neurodevelopmental outcome in risk neonates has raised the highest interest in recent years. Preterm infants are recognized to be at risk for neurodevelopmental (ND) sequelae even in absence of major cerebral lesions. The abnormal milieu of preterm extrauterine life, in particular ischaemia and inflammation, make preterm infants susceptible to cerebral injury potentially leading to ND sequelae even in absence of major cerebral lesions [1]. The aim of the present study is to evaluate whether rEpo, given at the high cumulative doses utilized for Luciano et al Italian Journal of Pediatrics (2015) 41:64 hematologic purposes, has improved the ND outcome in a series of preterm neonates free from major cerebral lesions or major visual impairment compared with a series of untreated neonates born at similar GA. The clinical variables potentially influencing the outcome have been investigated as well
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