Enterally Recombinant Erythropoietin Stimulates Erythropoiesis in Preterm Infants

Objective: Erythropoietin (Epo) is an essential hormone for erythropoiesis. Parenterral recombinant erythropoietin (rEpo) is effective for prevention of anemia of prematurity (AOP). The aim of this study was to determine the effect of enteral rEpo on erythropoiesis in preterm infants. Material & Methods: This is a randomized clinical trial (RCT) study performed on preterm infants (£1800gr birth weight and £34 weeks gestational age [GA]). Two groups of infants were randomly included in the study by sequential admissions. One group (n=7) received Epo (CIMBA. Cuba) 1200U/kg per week (3 days a week) plus ferrous sulfate (3-6 mg/kg/day). The control group (n=7) received only ferrous solfate. Hemoglobin (HB), Hematocrit (Hct) reticulocyte count, serum Epo and ferritin level were measured at baseline, after 10 days and on discharge. Collected data were tested by T-test and repeated measurement and analyzed by SPSS software. Findings: Mean (SD) GA of control group (n=7) were 30.3 (0.9) weeks and Epo group (n=7) were 30.7 (2.56) ( P =0.7). The mean (SD) body weight of control group was 1392 (196) gr and Epo group 1328 (267) gr. Reticulocytes count at the end of study in Epo group was significantly more than in control groups [2.99 (1.45) vs 1.36 (0.96)] ( P <0.009). Serum mean erythropoietin level in Epo group was significantly more than in control group [18 (11) vs 8.7 (4)] ( P= 0.006). Mean serum ferritin level in Epo group was lower than in control group although statically not significant [238 (78.59) vs 340 (166.51)] (P =0.4). There was no significant difference in Hb and Hct between the two groups ( P =0.3). Conclusion: Oral administration of rEpo increased significantly serum Epo and reticulocytes count  (stimulated erythropoiesis) but did not increase Hb and Hct in preterm infants.