title: Human recombinant erythropoietin in asphyxia neonatorum: pilot trial.
abstract: 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.
authors.affiliation: Department of Neonatology, Tanta University, Tanta, Egypt.
authors.forename: Heba
authors.initials: H
authors.lastname: Elmahdy
authors.forename: Abdel-Rahman
authors.initials: AR
authors.lastname: El-Mashad
authors.forename: Hoda
authors.initials: H
authors.lastname: El-Bahrawy
authors.forename: Tareq
authors.initials: T
authors.lastname: El-Gohary
authors.forename: Ali
authors.initials: A
authors.lastname: El-Barbary
authors.forename: Hany
authors.initials: H
authors.lastname: Aly
mesh_terms: 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
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin; D009569:Nitric Oxide