Early iron supplementation in preterm infants with erythropoietin treatment: safety and efficiency

Objectives To evaluate the efficiency and safety of early iron supplementat ion in very-low-birth-weight infants receiving recombinant human erythropoi etin (rhEPO). Methods Seventy-eight subjects were included in a prospective cohort study. Hematological indices and transfusion needs were compared in 39 infants tr eated with rhEPO and iron (treated group) for 6 weeks, and in 39 untreated infants (control group). Side-effects of iron administration were recorded. Results The clinical characteristics, severity of illness, blood loss, hemo globin and hematocrit levels on days 3-5 were similar in both groups. Iron supplementation was well tolerated. At the end of the treatment period, the hemoglobin level was significantly higher in the treated group (113 +/- 3 g/l) than in the control group (96 +/- 2 g/l) (p = 0.001). Twice as many in fants received transfusions in the control group (26/39) as in the treated group (11/39). Infections were more frequent in the treated group (7/39) th an in the control group (1/39). Conclusions We observed a significant decrease in transfusion needs in pret erm infants treated with rhEPO and early iron supplementation. Further rand omized studies are needed to address the issue of the increased number of i nfections in infants treated with rhEPO and iron.