Erythropoietin (Epo), protein and iron supplementation and the prevention of anaemia of prematurity: effects on serum immunoreactive Epo, growth and protein and iron metabolism.
The effect of recombinant human (r-Hu) erythropoietin (Epo) (300 IU/Kg per week for 4 weeks) was studied in healthy preterm infants (n = 14) fed human milk with additional milk protein and high doses of iron. The controls (n = 15) were in themselves a study group and were used to follow the natural course of anaemia of prematurity on such nutrition. Serum immunoreactive Epo (SiEpo) increased significantly 24 h after r-HuEpo injections (range 36 to > 128 mU/ml) and remained at these levels throughout the treatment period. r-HuEpo in such moderate doses kept haemoglobin above 11 g/dl. Bodyweight gain, protein and iron parameters indicated adequacy of dietary protein and iron. In controls, siEpo increased during the first weeks after nutritional supplementation, with a concommitant rise in reticulocyte count. At age 3 weeks, despite low siEpo levels, reticulocyte counts indicated active erythropoiesis. Following further moderate increases in siEpo, the reticulocyte count increased to high levels (7%). The reticulocyte response suggests that erythropoiesis in preterm infants is less dependent upon Epo levels than in adults.
Bechensteen
A G
AG
Department of Paediatrics, Ullevål Hospital, Norway.
Halvorsen
S
S
Hågå
P
P
Cotes
P M
PM
Liestøl
K
K
D000751:Anemia, Neonatal / Q000378:metabolism / Q000517:prevention & control*; D003131:Combined Modality Therapy; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000378:metabolism; D004921:Erythropoietin / Q000097:blood / Q000627:therapeutic use*; D005296:Ferrous Compounds / Q000378:metabolism / Q000627:therapeutic use*; D006128:Growth / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000378:metabolism / Q000517:prevention & control*; D011994:Recombinant Proteins / Q000097:blood / Q000627:therapeutic use*; D017701:Reticulocyte Count
D004044:Dietary Proteins; D005296:Ferrous Compounds; D011994:Recombinant Proteins; D004921:Erythropoietin; C031621:ferrous fumarate