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Arch Dis Child Fetal Neonatal Ed. 2016 Sep;101(5):F458-63. doi: 10.1136/archdischild-2015-309127. Epub 2016 May 12.

Systemic endogenous erythropoietin and associated disorders in extremely preterm newborns.

Author information

1
Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA.
2
Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
3
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA Perinatal Neuroepidemiology Unit, Hannover School of Medicine, Hannover, Germany.
4
Laboratory of Genital Tract Biology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, USA.
5
Harvard Medical School, Boston, USA.
6
Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.

Abstract

OBJECTIVE:

To explore the association between concentrations of endogenous erythropoietin (EPO) in blood the first 2 weeks of life and neonatal disorders in extremely low gestational age newborns (ELGANs).

DESIGN:

Prospective cohort study.

SETTING:

Neonatal care units at 14 participating hospitals in the USA.

PATIENTS:

867 children born before the 28th week of gestation from the ELGAN study cohort.

MAIN OUTCOME MEASURES:

EPO blood concentrations were measured on postnatal days 1, 7 and 14. The following neonatal characteristics and disorders were registered: blood gases, early and late respiratory dysfunction, pulmonary deterioration, retinopathy of prematurity (ROP), necrotising enterocolitis (NEC) and bronchopulmonary dysplasia (BPD). We calculated the gestational age-adjusted ORs for having each disorder associated with an EPO blood concentration in the highest or lowest quartile, compared with infants whose EPO concentration was in the middle two quartiles on the corresponding day.

RESULTS:

Newborns whose day-1 EPO was in the highest quartile were at increased risk for early and persistent respiratory dysfunction during the first 2 weeks of life, and NEC requiring surgery. The lowest EPO quartile on day 1 was associated with a decreased risk of moderate BPD. The association between low EPO and decreased risk of respiratory complications persisted on day 7. On day 14, being in the highest EPO quartile was associated with increased risk of ROP, and BPD not requiring ventilation assistance.

CONCLUSIONS:

EPO blood concentrations in extremely preterm newborns during the first 2 weeks of life convey information about increased risks of bowel, lung and retinal diseases.

KEYWORDS:

Endocrinology; Epidemiology; Neonatology; Ophthalmology; Respiratory

[Indexed for MEDLINE]

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