Use of epoetin alfa in very preterm infants with birthweight below 1500 gram

Abstract

Purpose of the research was to evaluate the effect of the administration of epoetin alfa (Eralfon®️) after 8 days of life in very preterm infants with birthweight below 1500 gram and gestational age below 310/7 weeks on the anemia of prematurity, on hemoglobin levels in blood at the age of six months and on retinopathy of prematurity. Materials and methods used: a retrospective study of 105 very preterm infants was conducted at the two perinatal centers, L.A. Vorokhobov Moscow City Clinical Hospital No. 67 of the Moscow Department of Healthcare (Moscow, Russia) and Yaroslavl Oblast Regional Perinatal Center (Yaroslavl, Russia), who were divided into two groups, G1 (56) who did not receive epoetin alpha (EA) at 1 to 2 months of life (the so-called “no EA Group”) and were nursed at the Yaroslavl Oblast Regional Perinatal Center; and G2 (49) who received EA at 1 to 2 months of life (the “EA Group”) and were nursed at the L.A. Vorokhobov Moscow City Clinical Hospital No. 67 of the Moscow Department of Healthcare. In the “EA Group,” there was late (after the 8th day of life) EA administration at a dose of 200 units/kg at once subcutaneously 3 times per week for 6 weeks. Results: hemoglobin levels in peripheral blood on the first day of life had no statistically significant differences. The level of hemoglobin in peripheral blood at the age of 6 months was statistically significantly higher in preterm infants who had received EA at 1 to 2 months of life. The development of the anemia of prematurity was statistically significantly less frequently recorded in the “EA Group:” 40 out of 49 (82.0%) vs. 54 out of 56 (96.0%), p=0.022. Erythrocyte transfusion in the “no EA Group” was performed in 38 out of 56 (67.8%), 25 out of 49 (51.0%) in the “EA group,” p=0.079, OR 0.49 [0.22, 1.08], RR 0.71 [0.47, 1.06]. Children who were in need of high-frequency oscillatory ventilation (HFOV) have not only had statistically significantly more frequent need for erythrocyte transfusion but also statistically significantly more often developed BPD and retinopathy of prematurity at the stage that requires surgical intervention. Conclusion: late EA administration in preterm infants with birthweight below 1500 gram reduces the risk of the development of the anemia of prematurity, increases the level of hemoglobin in peripheral blood at the age of six months old and does not increase the risk for development of retinopathy of prematurity.