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    Does EPO benefit neurodevelopment in very preterm babies?

    Results from a new randomized, double-blind, placebo-controlled, multicenter trial published in JAMA show that very preterm infants may not have better neurodevelopmental outcomes when they receive prophylactic early high-dose recombinant human erythropoietin (rhEPO).

    Researchers studied 448 preterm infants in Switzerland from 2005 to 2012. The infants were randomized to receive either rhEPO (3000 IU/kg) or placebo (isotonic saline, 0.9%) intravenously within 3 hours of birth, at 12 to 18 hours following birth, and at 36 to 42 hours after birth. Cognitive development was assessed with the Mental Development index of the Bayley Scales of Infant Development.

    Among the 448 infants who were randomized (mean gestational age, 29.0 [range, 26.0-30.9] weeks; 264 [59%] female; mean birth weight, 1210 [range, 490-2290] g), 220 were randomly assigned to be administered the placebo and 228 were selected to receive the rhEPO. Neurodevelopmental outcome data were available for 365 infants, 81%) at an average age of 23.6 months. In an intention-to-treat analysis, the average Mental Development Index showed no statistical difference between the rhEPO group (93.5 [Standard Deviation {SD}, 16.0] [95% CI, 91.2 to 95.8]) and the placebo group (94.5 [SD, 17.8] [95% CI, 90.8 to 98.5]) (difference, −1.0 [95% CI, −4.5 to 2.5]; P = .56). Among secondary outcomes such as cerebral palsy and hearing or visual impairment, no differences were found.

    Next: CDC reports on infant versus fetal mortality

    The researchers concluded that a prophylactic early high-dose of rhEPO provides no statistically significant neurodevelopmental benefit for infants born between 26 weeks and 0 days and 31 weeks and 6 days gestation. They did say that get a fuller picture, follow-up is needed on cognitive and physical problems that may not become evident until later in life.

    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.


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