Erythropoietin and retinopathy of prematurity: a retrospective cohort study in Japan, 2008-2018

Kana Fukui; Yushi Ito; Masayo Kokubo; Hidehiko Nakanishi; Shinya Hirano; Satoshi Kusuda; Shuichi Ito; Tetsuya Isayama; Neonatal Research Network of Japan

doi:10.1038/s41372-024-01929-z

Erythropoietin and retinopathy of prematurity: a retrospective cohort study in Japan, 2008-2018

J Perinatol. 2024 Mar 21. doi: 10.1038/s41372-024-01929-z. Online ahead of print.

Authors

Kana Fukui^{1

2}, Yushi Ito¹, Masayo Kokubo³, Hidehiko Nakanishi⁴, Shinya Hirano⁵, Satoshi Kusuda⁶, Shuichi Ito², Tetsuya Isayama^{7

8}; Neonatal Research Network of Japan

Collaborators

Neonatal Research Network of Japan:
Kana Fukui, Yushi Ito, Masayo Kokubo, Hidehiko Nakanishi, Shinya Hirano, Satoshi Kusuda, Shuichi Ito, Tetsuya Isayama

Affiliations

¹ Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan.
² Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan.
³ Division of Neonatology, Nagano Children's Hospital, Nagano, Japan.
⁴ Research and Development Center for New Medical Frontiers, Division of Neonatal Intensive Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
⁵ Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan.
⁶ Department of Pediatrics, Kyorin University, Tokyo, Japan.
⁷ Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan. isayama-t@ncchd.go.jp.
⁸ Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan. isayama-t@ncchd.go.jp.

PMID: 38514743
DOI: 10.1038/s41372-024-01929-z

Abstract

Background: Erythropoietin has an angiogenic effect on the retina and might increase the risk of retinopathy of prematurity (ROP).

Methods: This retrospective cohort study included infants born at 22 to 27 weeks' gestation between 2008 and 2018 who were admitted to neonatal intensive care units (NICUs). We compared mortality and morbidities between infants who received erythropoietin and those who did not.

Results: Among 18,955 livebirth infants, this study included 16,031 infants, among which 14,373 infants received erythropoietin. The risk of ROP requiring treatment was significantly higher in the erythropoietin group than in the control group (33% vs. 26%; aOR 1.50 [95% CI 1.28-1.76]). On the other hand, the erythropoietin group had lower risks of death and necrotizing enterocolitis.

Conclusions: This study with a large sample size found that erythropoietin use was associated with increased risk of ROP requiring treatment, while being associated with reductions in deaths and NEC.