Erythropoietin and the incidence of necrotizing enterocolitis in infants with very low birth weight

Background/Purpose: The presence of erythropoietin (Epo) in human milk and the expression of Epo receptors on intestinal villous enterocytes of neonat es suggest that Epo has a role in growth and development of the gastrointes tinal tract. On this basis, the authors hypothesized that recombinant Epo ( rEpo) given for prevention or treatment of the anemia of prematurity would protect against necrotizing enterocolitis (NEC). Methods: A retrospective cohort study was conducted from a university neona tal intensive care unit of 483 very low birth weight (500 to 1,250 g) neona tes born from July 1, 1993 to January 1, 1998. Results: A total of 260 neonates received rEpo, and 223 did not (control gr oup). The rEpo and control groups were similar in gender distribution (52% v 48% boys), gestational age (26.8 +/- 2.1 v 27.6 +/- 2.9 weeks; mean +/- S D), birth weight (895 +/- 198 v 911 +/- 208 g), 1 and 5 minute Apgar scores (4.2 and 6.1 v4.7 and 6.7), end incidence of severe intraventricular hemor rhage (8.9% v 10.3%). The rEpo group had a lower incidence of NEC (12 of 26 0, 4.6% v24 of 223, 10.8%; P =.028, 95% confidence interval for difference: -0.208 to -0.015). Conclusion: In very low birth weight infants, the incidence of NEC is lower in those who received rEpo. J Pediatr Surg 35:178-782, Copyright (C) 2000 by W.B. Saunders Company.