Objective
The neuroprotective effect of erythropoietin has been proven in several brain injury models. It has not been evaluated in the neonatal hypoxia-ischemia encephalopathy (HIE). The purpose of this study was to evaluate the clinical effect of erythropoietin on neonatal HIE by systemic injection.
Methods
Fifty-eight asphyxiated newborns were enrolled this study in our neonatal section who fulfilled the criteria of moderate to severe HIE, with the exception of gestation age <37 week's, body weight <2.5 kg, severe congenital abnormities and hemorrhage. The infants were randomized to either EPO-treated group with the dosage of 300 U/kg/time or control group without EPO treatment. The recombinant human erythropoietin (r-hu-EPO) was injected intravenously for each other day with 3 times each week for 2 weeks. The supportive care was same among the groups. The short-term effect of EPO was evaluated by Neonatal Behavioral Neurological Assessment (NBNA) on day 7, 14 and 28. The long-term effect was evaluated by measuring neurodevelopment quote on 3 and 6 months of age.
Results
There were 29 cases in EPO-treated group and 29 cases in control group. There were no differences in gestation age, birth weight, sex and clinical symptoms between two groups (P>0.05). The scoring of NBNA showed a significant difference between EPO treated groups and control group (P<0.05). The DQ scores at the 3rd and 6th month in low dose EPO-treated group (89.17±7.11, 90.85±9.14) were significantly higher than that of control group (77.38±10.97, 78.92±11.24) (P<0.05).
Conclusion
EPO treatment could promote neurological recovery, improve long-term neurobehavioral development.