Erythropoietin monotherapy for neuroprotection after neonatal encephalopathy in low 2 to-middle income countries: A systematic review and meta-analysis
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective: We examined whether erythropoietin monotherapy improves neurodevelopmental outcomes in near-term and term infants with neonatal encephalopathy (NE) in low-middle income countries (LMICs). Methods: We searched Pubmed, Embase, and Web of Science databases to identify studies that used erythropoietin (1,500 to 12,500 units/kg/dose) or a derivative to treat NE. Results: Five studies, with a total of 348 infants in LMICs, were retrieved. However, only three of the five studies met the primary outcome of death or neuro-disability at 18 months of age or later. Erythropoietin reduced the risk of death (during neonatal period and at follow55 up) or neuro-disability at 18 months or later (p<0.05). Death or neuro-disability occurred in 27.6% of the erythropoietin group and 49.7% of the comparison group (Risk Ratio 0.56 (95% CI: 0.42 to 0.75). Conclusion: The pooled data suggests that erythropoietin monotherapy may improve outcomes after NE in LMICs where therapeutic hypothermia is not available.
Date Issued
2021-06-26
Date Acceptance
2021-06-04
Citation
Journal of Perinatology, 2021, 41, pp.2134-2140
ISSN
0743-8346
Publisher
Springer Nature [academic journals on nature.com]
Start Page
2134
End Page
2140
Journal / Book Title
Journal of Perinatology
Volume
41
Replaces
10044/1/86437
Copyright Statement
© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
Medical Research Council (MRC)
National Institute for Health Research
National Institute for Health Research
Identifier
https://www.nature.com/articles/s41372-021-01132-4
Grant Number
MR/R001375/1
NIHR200144
NIHR301082
Subjects
Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
Pediatrics
DOSE RECOMBINANT ERYTHROPOIETIN
HYPOXIC-ISCHEMIC ENCEPHALOPATHY
NEUROLOGICAL FUNCTION
PERINATAL ASPHYXIA
HYPOTHERMIA
OUTCOMES
SAFETY
NEUROGENESIS
DARBEPOETIN
MODERATE
Developing Countries
Erythropoietin
Humans
Hypothermia, Induced
Hypoxia-Ischemia, Brain
Infant
Infant, Newborn
Neuroprotection
Humans
Hypoxia-Ischemia, Brain
Erythropoietin
Hypothermia, Induced
Developing Countries
Infant
Infant, Newborn
Neuroprotection
Pediatrics
1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
Publication Status
Published
Date Publish Online
2021-06-26