Erythropoietin and the incidence of necrotizing enterocolitis in infants with very low birth weight

J Pediatr Surg. 2000 Feb;35(2):178-81; discussion 182. doi: 10.1016/s0022-3468(00)90006-x.


Background/purpose: The presence of erythropoietin (Epo) in human milk and the expression of Epo receptors on intestinal villous enterocytes of neonates suggest that Epo has a role in growth and development of the gastrointestinal tract. On this basis, the authors hypothesized that recombinant Epo (rEpo) given for prevention or treatment of the anemia of prematurity would protect against necrotizing enterocolitis (NEC).

Methods: A retrospective cohort study was conducted from a university neonatal intensive care unit of 483 very low birth weight (500 to 1,250 g) neonates born from July 1, 1993 to January 1, 1998.

Results: A total of 260 neonates received rEpo, and 223 did not (control group). The rEpo and control groups were similar in gender distribution (52% v. 48% boys), gestational age (26.8+/-2.1 v. 27.6+/-2.9 weeks; mean +/- SD), birth weight (895+/-198 v. 911+/-208 g), 1 and 5 minute Apgar scores (4.2 and 6.1 v4.7 and 6.7), and incidence of severe intraventricular hemorrhage (8.9% v. 10.3%). The rEpo group had a lower incidence of NEC (12 of 260, 4.6% v. 24 of 223, 10.8%; P = .028, 95% confidence interval for difference: -0.108 to -0.015).

Conclusion: In very low birth weight infants, the incidence of NEC is lower in those who received rEpo.

MeSH terms

  • Enterocolitis, Necrotizing / prevention & control*
  • Erythropoietin / therapeutic use*
  • Female
  • Humans
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Male
  • Recombinant Proteins
  • Retrospective Studies


  • Recombinant Proteins
  • Erythropoietin