Anemia of prematurity pdf

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By the end of , over 20 controlled clinical trials assessing the efficacy of r-HuEPO to eliminate RBC transfusions in the anaemia of prematurity were published with inconsistent results. To investigate the extent and reasons for the inconsistencies, a meta-analysis was conducted of the controlled clinical studies published between thru Two major conclusions emerged from the meta-analysis. Hence, it was judged premature to make firm recommendations regarding use of r-HuEPO in clinical practice to treat the anaemia of prematurity.

Second, when the four studies with highly desired characteristics were analyzed separately, r-HuEPO was found to be efficacious in significantly reducing RBC transfusion needs. However, the magnitude of the effect of r-HuEPO on reducing the total RBC transfusions given to infants throughout their initial hospitalization was, in fact, relatively modest and of questionable clinical importance.

Because meta-analysis of reports through did not give firm guidelines for the use of r-HuEPO, neonatologists must determine if reports published after have provided useful information. During the first three weeks of life, r-HuEPO increased reticulocytes and hematocrit values, but there was no difference in RBC transfusions between groups. Similarly, Yeo et al 37 found a modest advantage for a subgroup of very low birth weight infants given r-HuEPO.

Infants with birth weight 0. Maier et al 39 randomized neonates with birth weights 0. Avent et al 40 randomized 93 neonates with birth weight 0. Treatment began within 7 days of life and continued until discharge median 32 days and maximum 74 days. To be selected for analysis, the clinical trials had to include ventilated infants ie, sick infants likely to receive RBC transfusions.

The authors found that, when restrictive transfusion guidelines were followed, the number of RBC transfusions and the volume of RBCs transfused were similarly low in infants either given or not given r-HuEPO. Recombinant human erythropoietin, although clearly stimulating erythropoiesis in infant marrow, has very limited use, currently, to treat the anaemia of prematurity.

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National Center for Biotechnology Information , U. Blood Rev. Author manuscript; available in PMC Nov 1. Ronald G Strauss , MD.

Author information Copyright and License information Disclaimer. Ronald G Strauss: ude. Copyright notice. The publisher's final edited version of this article is available at Blood Rev. See other articles in PMC that cite the published article.

Pathophysiology of the Anaemia of Prematurity All neonates experience a decline in circulating RBCs during the first weeks of life.

Open in a separate window. Thus, any value within range is acceptable for local practices. Recombinant Erythropoietin to Treat the Anaemia of Prematurity Recognition of low plasma EPO levels and normally responsive RBC progenitor cells in preterm infants provides a rational basis to consider recombinant human erythropoietin r-HuEPO as treatment for the anaemia of prematurity.

Practice Points RBC transfusions are the key treatment modality for the anaemia of prematurity. Vigorous attempts must be made to limit volumes of blood drawn for laboratory testing. Footnotes Conflict of interest statement None to declare. References 1. Births: final data for national Vital Statistics Reports. Pathophysiology of anemia during the neonatal period, including anemia of prematurity. Iron homeostasis disruption and oxidative stress in preterm newborns.

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Home Health Library. A physical exam will be done. Your baby's blood will be tested. This can be done with blood tests. Treatment Treatment will depend on the cause of anemia. Iron is important in making RBCs. Some babies may be given supplemental iron.

Blood Transfusion Some babies with severe problems may need treatment right away. Mothers should take steps to prevent premature birth: Avoid alcohol, smoking, and drugs. Eat a healthy, balanced diet with plenty of fruits and vegetables. Manage chronic health problems. Provide proper nutrition to babies.

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