Human recombinant erythropoietin and the incidence of retinopathy of prematurity: a multiple regression model.
BACKGROUND
Recombinant human erythropoietin (rhEPO) is used for the treatment of anemia of prematurity. However, it has also been found to have properties similar to vascular endothelial growth factor (VEGF), the major angiogenic factor implicated in the pathogenesis of retinopathy of prematurity (ROP). We sought to determine whether rhEPO is an independent risk factor for the development of ROP.


METHODS
Data were analyzed from 264 infants admitted to the Loma Linda University Children's Hospital neonatal intensive care unit in 1994 and 2002. The data included demographic characteristics, incidence of major morbidities, rhEPO treatment, number of red blood cell transfusions received, and incidence and severity of ROP. A multiple logistic regression model was used to determine the relation of the studied risk factors to the incidence (any stage) and severity (threshold ROP requiring cryotherapy or laser photocoagulation) of ROP.


RESULTS
The risk of developing ROP increased among infants who received >20 doses of rhEPO was higher compared with those who received < or =20 doses (OR, 3.53; 95% CI, 1.59, 7.85). These infants were also more likely to require laser photocoagulation (OR, 4.31; 95% CI, 1.99, 9.33). The age at which rhEPO was started was also a significant risk factor, with those starting rhEPO after 20 days of age having almost fourfold the risk of ROP compared with those starting it on or before 20 days of age (OR, 3.57; 95% CI, 1.59, 8.03).


CONCLUSIONS
rhEPO was found to be a significant independent risk factor for the development of ROP.
Suk
Kevin K
KK
Loma Linda University, School of Medicine, Loma Linda, California 92354, USA.
Dunbar
Jennifer A
JA
Liu
Anthony
A
Daher
Noha S
NS
Leng
Cheri K
CK
Leng
Jason K
JK
Lim
Pauline
P
Weller
Samantha
S
Fayard
Elba
E
D000367:Age Factors; D000751:Anemia, Neonatal / Q000188:drug therapy; D001724:Birth Weight; D002140:California / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000008:administration & dosage / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D015233:Models, Statistical; D011379:Prognosis; D011994:Recombinant Proteins; D012044:Regression Analysis; D012178:Retinopathy of Prematurity / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
D011994:Recombinant Proteins; D004921:Erythropoietin