Human recombinant erythropoietin in asphyxia neonatorum: pilot trial.
OBJECTIVE
The goal was to examine biochemical, neurophysiologic, anatomic, and clinical changes associated with erythropoietin administration to neonates with hypoxic-ischemic encephalopathy (HIE).


METHODS
We conducted a prospective case-control study with 45 neonates in 3 groups, a normal healthy group (N = 15), a HIE-erythropoietin group (N = 15; infants with mild/moderate HIE who received human recombinant erythropoietin, 2500 IU/kg, subcutaneously, daily for 5 days), and a HIE-control group (N = 15; did not receive erythropoietin). Serum concentrations of nitric oxide (NO) were measured at enrollment for the normal healthy neonates and at enrollment and after 2 weeks for the 2 HIE groups. The 2 HIE groups underwent electroencephalography at enrollment and at 2 to 3 weeks. Brain MRI was performed at 3 weeks. Neurologic evaluations and Denver Developmental Screening Test II assessments were performed at 6 months.


RESULTS
Compared with normal healthy neonates, the 2 HIE groups had greater blood NO concentrations (P < .001). At enrollment, the 2 HIE groups did not differ in clinical severity, seizure incidence, NO concentrations, or electroencephalographic findings. At 2 weeks of age, electroencephalographic backgrounds improved significantly (P = .01) and NO concentrations decreased (P < .001) in the HIE-erythropoietin group, compared with the HIE-control group; MRI findings did not differ between groups. At 6 months of age, infants in the HIE-erythropoietin group had fewer neurologic (P = .03) and developmental (P = .03) abnormalities.


CONCLUSIONS
This study demonstrates the feasibility of early administration of human recombinant erythropoietin to term neonates with HIE, to protect against encephalopathy.
Elmahdy
Heba
H
Department of Neonatology, Tanta University, Tanta, Egypt.
El-Mashad
Abdel-Rahman
AR
El-Bahrawy
Hoda
H
El-Gohary
Tareq
T
El-Barbary
Ali
A
Aly
Hany
H
D001238:Asphyxia Neonatorum / Q000188:drug therapy*; D001921:Brain / Q000098:blood supply / Q000187:drug effects / Q000473:pathology; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis / Q000188:drug therapy*; D007223:Infant; D007231:Infant, Newborn; D007279:Injections, Subcutaneous; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination / Q000187:drug effects; D009569:Nitric Oxide / Q000097:blood; D011446:Prospective Studies; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D004921:Erythropoietin; D009569:Nitric Oxide