[Early administration of erythropoietin in the extreme premature, a risk factor for retinopathy of prematurity?].
BACKGROUND
Erythropoietin (EPO) stimulates angiogenesis and may favour the appearance of retinopathy of prematurity (ROP). The objective was to determine if EPO+Fe administered from the 5th day of life could be an independent risk factor for ROP appearance and its severity.


METHODS
The study included 718 preterm newborns with a birth weight ≤1,500g or a gestational age ≤32 weeks (and 6 days), admitted between 2001 and 2008. During these years, the target SaO₂ was between 88% and 93%. EPO treatment began at 5-7 days of life, with a dose of 250 UI/Kg, 3 times a week, subcutaneously, together with Fe, 5-6mg/kg/day, both until 34 weeks of corrected age or discharge.


RESULTS
A total of 493 preterms (68.7%) did not have ROP, 139 (19.4%) had a grade 1 ROP, 50 (7.0%) a grade 2 ROP and 36 (5.0%) a grade 3 ROP. Laser therapy was required by 27 severe ROP was associated with lower birth weight and gestational age, more neonatal morbidity and a more aggressive treatment (duration of oxygen supplements or mechanical ventilation, number of blood transfusions). Risk factors independently and significantly associated with any ROP grade were: lower birth weight, no caesarean section, EPO administration and need for blood transfusion. EPO administration increased the risk of ROP by 2.4, but this only happened in case of grade 1 ROP (OR: 5.50).


CONCLUSIONS
EPO+Fe administration is associated and perhaps stimulates the appearance of grade 1 ROP.
Figueras-Aloy
J
J
ICGON, Hospital Clínico, Universidad de Barcelona, España. jfiguer@clinic.ub.es
Alvarez-Domínguez
E
E
Morales-Ballus
M
M
Salvia-Roiges
M D
MD
Moretones-Suñol
G
G
D004921:Erythropoietin / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007501:Iron / Q000008:administration & dosage; D008297:Male; D011994:Recombinant Proteins; D012178:Retinopathy of Prematurity / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron