Abstract Objective To evaluate the clinical effects of the early use of recombinant human erythropoietin (rhEPO) on the neurointelligence development in very low birth weight infants (VLBWI). Methods Seventy-eight VLBWI were divided into rhEPO treatment group (n=35) and control group (n=43) according to the choice of their parents. Neonatal behavioral neurological assessment (NBNA) was performed at 40 weeks of corrected gestational age. The Gesell Developmental Schedules were used for neurodevelopmental evaluation at 3, 6, and 12 months of corrected age. The abnormal rates of auditory brainstem response (ABR) and cranial ultrasound were evaluated at 6 months of corrected age. Results The rhEPO treatment group had significantly higher NBNA scores at 40 weeks of corrected gestational age than the control group (P<0.05). The adaptability at 3 months of corrected age, the gross motor, adaptability, and sociability at 6 months, and the gross motor, adaptability, fine motor, sociability, and language at 12 months were significantly better in the rhEPO treatment group than in the control group (P<0.05). The abnormal rates of ABR and cranial ultrasound in the rhEPO treatment group were significantly lower than in the control group at 6 months of corrected age (P<0.05). Conclusions Early use of rhEPO can promote the early recovery of neurological symptoms and improve the cognitive, motor, and language abilities in VLBWI due to its protective effects on the nervous system.
CAI Yue-Ju,SONG Yan-Yan,HUANG Zhi-Jian et al. Effects of recombinant human erythropoietin on neurointelligence development in very low birth weight infants[J]. CJCP, 2013, 15(12): 1064-1067.
CAI Yue-Ju,SONG Yan-Yan,HUANG Zhi-Jian et al. Effects of recombinant human erythropoietin on neurointelligence development in very low birth weight infants[J]. CJCP, 2013, 15(12): 1064-1067.
Hahn WH, Chang JY, Chang YS, Shim KS, Bae CW. Recent trends in neonatal mortality in very low birth weight Korean infants: in comparison with Japan and the USA[J]. J Korean Med Sci, 2011, 26(4): 467-473.
Kumral A, Baskin H, Gokmen N, Yilmaz O, Genc K, Genc S, et al. Selective inhibition of nitric oxide in hypoxic-ischemic brain model in newborn rats: is it an explanation for the protective role of erythropoietin[J]. Biol Neonate, 2004, 85(1): 51-54.
Anand KJ. Clinical importance of pain and stress in preterm neonates[J]. Biol Neonate, 1998, 73(1): 1-9.
[6]
Kim SS, Lee KH, Sung DK, Shim JW, Kim MJ, Jeon GW, et a1. Erythropoietin attenuates brain injury, subventicular zone expansion, and sen-sorimotor deficits in hypoxic-ischemic neonatal rats[J]. Korean Med Sci, 2008, 23(3): 484-491．
[7]
Sun Y, Calvert JW, Zhang JH. Neonatal hypoxia/ischemia is associated with decreased inflammatory mediators after erythropoietin administration[J]. Stroke, 2005, 36(8): 1672-1678.
Brown MS, Eichorst D, Lala-Black B, Gonzalez R. Higher cumulative doses of erythropoietin and developmental outcomes in preterm infants[J]. Pediatrics, 2009, 124(4): e681-e687.
[11]
Juul SE, McPherson RJ, Bauer LA, Ledbetter KJ, Gleason CA, Mayock DE. A phaseⅠ/Ⅱtrial of high-dose erythropoietin in extremely low birth weight infants: pharmacokinetics and safety[J]. Pediatrics, 2008, 122(2): 383-391.
[12]
Fauchere JC, Dame C, Vonthein R, Koller B, Arri S, Wolf M, et al. An approach to using recombinant erythropoietin for neuroprotection in very preterm infants[J]. Pediatrics, 2008, 122(2): 375-382.
[13]
Neubauer AP, Voss W, Wachtendorf M, Jungmann T. Erythropoietin improvesneurodevelopmental outcome of extremely preterm infants[J]. Ann Neurol, 2010, 67(5): 657-666.
[14]
Ohlsson A, Aher S. Early erythropoietin for preventing red blood cell transfusion in preterm and/or low birth weight infants[J]. Cochrane Database Syst Rev, 2012, 12(9): CD004863.
[15]
Brown MS, Baron AE, France EK, Hamman RF. Association between higher cumulative doses of recombinant erythropoietin and risk for retinopathy of prematurity[J]. J AAPOS, 2006, 10(2): 143-149.
[16]
Zaffanello M, Franchini M, Rugolotto S. Recombinant human erythropoietin might induce strawberry haemangiomas in very-low-birthweight preterm infants[J]. Acta Paediat, 2003, 92(11): 1353-1354.
