Groundbreaking Treatment for Oxygen-Deprived Newborns

A new treatment for newborns suffering from oxygen deprivation during delivery involves a two-week course of injections of erythropoietin that can be started as late as two days after birth.

Researchers from Sahlgrenska Academy (Gothenburg, Sweden), in collaboration with Zhengzhou University (China) conducted a study involving a total of 167 full-term infants with moderate to severe neonatal hypoxic-ischemic encephalopathy (HIE), who were assigned randomly to receive either erythropoietin (83 newborns) or conventional treatment (84 newborns). Recombinant human erythropoietin, at either 300 U/kg or 500 U/kg, was administered every other day for two weeks, starting at most at 48 hours after birth. The primary outcome was death or disability, and neurodevelopmental outcomes were assessed at 18 months of age. Of the 167 patients, 9 dropped out during treatment, and 5 patients were lost to follow-up monitoring.

The researchers found that death or moderate-to-severe disability occurred in 35 (43.8%) of 80 infants in the control group and 18 (24.6%) of 73 infants in the erythropoietin group at 18 months. The primary outcomes were similar between the two erythropoietin doses. Subgroup analyses indicated that erythropoietin improved long-term outcomes only for infants with moderate HIE, and not those with severe HIE. No negative hematopoietic side effects were observed. The study was published in the August 2009 issue of the journal Pediatrics.

"For the first time we can demonstrate that it is possible to influence the brain damage occurring as a result of oxygen deprivation during delivery considerably later than the six-hour window of opportunity for treating with cooling,” said lead author Klas Blomgren, M.D., Ph.D., a professor of pediatrics at the Sahlgrenska Academy. "This appears to be a safe treatment, almost without side effects, and it is also cheaper and technically simpler to administer in comparison with cooling.”

Erythropoietin is a glycoprotein hormone that controls erythropoiesis, or red blood cell (RBC) production; it is a cytokine for erythrocyte precursors in the bone marrow. Also called hematopoietin or hemopoietin, it is produced by the peritubular capillary endothelial cells in the kidney. Besides regulating RBC production, it has other known biological functions, including an important role in the brain's response to neuronal injury and in the wound healing process.

Related Links:
Sahlgrenska Academy
Zhengzhou University