Role of Erythropoietin in anemia of prematurity

Volume 15 , Issue 2 , December 2025 , Pages 253-262

Authors

Mohammad shukry Mohammad 1 ; Haider Fakher Mohammad 1

1 Department of Clinical Science, College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan Region/Iraq

DOI logo 10.17656/jsmc.10509

Keywords

Abstract

Background: Anemia of prematurity (AOP) is a common condition in preterm infants, typically manifesting within the first few weeks of life and reaching a hemoglobin nadir of 7–8 g/dL by 4–6 weeks. Erythropoietin, a glycoprotein hormone, has a key role in stimulating erythropoiesis. Aim of study: To investigate the role of late recombinant erythropoietin therapy in decreasing the need for red blood cell transfusions and preventing anemia of prematurity.

Methods: A randomized controlled trial was conducted in the hospital. During 6 6-month period, forty preterm neonates with gestational age 28–34 weeks and birth weight 900–2000 g were randomly assigned to two groups. The treatment group received rHuEPO (400 IU/kg, subcutaneously, three times per week) from the second week of life, combined with iron (6 mg/kg/day) and QuatreFolate (400 μg/day). The control group received only iron and QuatreFolate. Therapy continued for four weeks while all infants were on enteral feeding.

Result: Delayed initiation of rHuEPO combined with iron supplementation significantly reduced the requirement for blood transfusions compared with controls (20% vs 55%, p = 0.04). The treatment group also showed higher reticulocyte counts (p = 0.01) and higher final hematocrit levels (p = 0.015). No adverse effects were observed.  

Conclusion: Late administration of rHuEPO in combination with iron enhances erythropoiesis and reduces the need for transfusion in preterm infants. However, the inclusion of relatively stable, lower-risk neonates may limit the generalizability of the findings

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  • Published at21 December 2025

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