Erythropoietin Improves Poor Outcomes in Preterm Infants with Intraventricular Hemorrhage

Background Intraventricular hemorrhage (IVH) is a common complication in preterm infants that has poor outcomes, especially in severe cases, and there are currently no widely accepted effective treatments. Erythropoietin has been shown to be neuroprotective in neonatal brain injury. Objective The objective of this study was to evaluate the protective effect of repeated low-dose recombinant human erythropoietin (rhEPO) in preterm infants with IVH. Methods This was a single-blinded prospective randomized controlled trial. Preterm infants <= 32 weeks gestational age who were diagnosed with IVH within 72 h after birth were randomized to receive rhEPO 500 IU/kg or placebo (equivalent volume of saline) every other day for 2 weeks. The primary outcome was death or neurological disability assessed at 18 months of corrected age. Results A total of 316 eligible infants were included in the study, with 157 in the rhEPO group and 159 in the placebo group. Although no significant differences in mortality (p = 0.176) or incidence of neurological disability (p = 0.055) separately at 18 months of corrected age were seen between the rhEPO and placebo groups, significantly fewer infants had poor outcomes (death and neurological disability) in the rhEPO group: 14.9 vs. 26.4%; odds ratio (OR) 0.398; 95% confidence interval (CI) 0.199-0.796; p = 0.009. In addition, the incidence of Mental Development Index scores of p = 0.026. Conclusions Treatment with repeated low-dose rhEPO improved outcomes in preterm infants with IVH.

Automated summary

The study aimed to evaluate the protective effect of repeated low-dose rhEPO in preterm infants with IVH. While there were no significant differences in mortality or incidence of neurological disability, the rhEPO group had fewer poor outcomes, indicating a potential benefit. Additionally, rhEPO treatment also improved Mental Development Index scores at birth.