A meta-analysis of the efficacy and safety of early high-dose recombinant human erythropoietin in the prevention of anemia in premature infants
10.3760/cma.j.issn.2096-2932.2017.06.013
- VernacularTitle:早期大剂量重组人促红细胞生成素防治早产儿贫血的疗效和安全性Meta分析
- Author:
Miaomiao HU
1
;
泰山医学院附属医院新生儿科
;
Ji QI
;
Hui LI
;
Li WEI
;
Jing LI
Author Information
1. 271000 泰安,泰山医学院;泰山医学院附属医院新生儿科
- Keywords:
Erythropoietin;
recombinant;
Anemia;
Infant;
premature;
Meta-analysis
- From:Chinese Journal of Neonatology
2017;32(6):456-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of early use of high-dose rHu-EPO in the prevention of anemia in premature infants .Method Available data from clinical randomized controlled trials of early application of high-dose rHu-EPO to prevent premature infant anemia since database building till February 2017 were retrieved, which includes Pubmed, Embase, Cochrane Collaboration and CNKI , SinoMed, Wanfang, VIP.Premature infants less than gestational age of 37 weeks, with routine prevention of anemia as the control group and early combined use of high-dose rHu-EPO≥750 IU/( kg· w) as the treatment group.The relevant data from the literatures obtained were then screened and analyzed by the RevMan 5.3 software.Result A total of 1779 preterm infants from 21 articles including 898 cases of rHu-EPO treatment group and 881 cases in control group.Meta-analysis showed that rHu-EPO treatment group apparently increased the hemoglobin ( MD=27.42, 95%CI 20.01~34.84, P<0.001), hematocrit and reticulocyte count , reduced the blood transfusion. As to the risk of retinopathy of prematurity in rHu-EPO treatment group was significantly higher than that in the control group (RR=1.21, 95%CI 1.01~1.46, P=0.04), and reduced risks of bronchopulmonary dysplasia (RR=0.79, 95%CI 0.46 ~1.35, P =0.39) and patent ductus arteriosus ( RR =0.83, 95% CI 0.68 ~1.01, P=0.07) the difference, however, was not statistically significant, and there was no increasing risks of necrotizing enterocolitis , periventricular leukomalacia , intraventricular hemorrhage .Conclusion Early administration of high-dose of rHu-EPO can effectively prevent anemia in premature infants , but there is an increased risk of retinopathy of prematurity .
