A Meta-analysis Of The Efficacy And Safety Of Early High-dose Recombinant Human Erythropoietin In The Prevention And Treatment Of Anemia In Premature Infants

ObjectiveTo evaluate the efficacy and safety of early use of high-dose rHu-EPO in the prevention of anemia in premature infants.MethodAvailable 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 RevMan5.3 software.ResultA 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.ConclusionEarly administration of high-dose of rHu-EPO can effectively prevent anemia in premature infants,but there is an increased risk of retinopathy of prematurity.