Effect of administering recombinant erythropoietin to women with postpartum anemia: a meta-analysis.
OBJECTIVE
Recombinant erythropoietin (rEpo) has been administered to women with postpartum anemia in an attempt to accelerate their increase in hemoglobin concentration and reduce postpartum transfusions. However, it is not clear whether such an approach can be supported by evidence and should be generally recommended.


METHODS
Medical and scientific literature from January 1990 to December 2002 was searched and studies that reported the administration of rEpo to women with postpartum anemia were evaluated.


RESULTS
Eight evaluated studies reported an aggregate of 480 women; 300 rEpo recipients and 180 controls. Significant diversity in design was observed in rEpo dose, route of rEpo administration, iron supplementation, and baseline hemoglobin. No significant safety concerns were reported. In all five studies where it was reported, 4 to 7 days after beginning treatment, greater increases in hemoglobin concentration were observed among the rEpo recipients than among the controls. However, heterogeneity of results (Q-test statistic, p<0.01) indicated that it was not appropriate to apply summary statistics. The effect of rEpo on postpartum transfusion rate was not measurable by summary statistics because of the limited number of transfusions given (no transfusions among the 300 rEpo recipients vs two transfusions among the 180 controls).


CONCLUSIONS
Administration of rEpo to women with postpartum anemia appears to be safe, and is associated with a trend toward a faster increase in hemoglobin concentration. However, its efficacy in terms of diminishing postpartum transfusions is unproven.
Kotto-Kome
Anne C
AC
Division of Neonatology, Department of Pediatrics, University of South Florida College of Medicine, All Children's Hospital, St. Petersburg, FL 33772, USA.
Calhoun
Darlene A
DA
Montenegro
Raul
R
Sosa
Roberto
R
Maldonado
Luis
L
Christensen
Robert D
RD
D000328:Adult; D000740:Anemia / Q000175:diagnosis / Q000188:drug therapy*; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006454:Hemoglobins / Q000187:drug effects; D006801:Humans; D007279:Injections, Subcutaneous; D010500:Perinatology / Q000379:methods; D049590:Postpartum Period; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins; D012016:Reference Values; D016896:Treatment Outcome
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin