The effects of enteral artificial amniotic fluid-containing erythropoietin on short term outcomes of preterm infants

Özet

Necrotizing Enterocolitis (NEC) is a common devastating gastrointestinaldisease, which usually develops in premature infants. Erythropoietin (EPO) asa hematopoietic hormone produced by the kidney can also be naturally foundin amniotic fluid and breast milk. There is some evidence that supports thecontribution of EPO in the prevention of inflammation and intestinal tissuerepair. This study was aimed to determine if oral administration of artificialamniotic fluid with or without EPO would protect preterm infants against NECand improve the certain neonatal outcomes. In this study, 150 preterm infantswith gestational age 28 weeks or less and birth weight 1250 grams or lesswere enrolled. The infants were divided randomly into 3 groups: 1) Controlgroup (n=50) with routine feeding protocol without any administration; 2)Amniotic fluid group (n=50) with 5mL/kg synthetic amniotic fluid; 3) EPOgroup (n=50) with RhuEPO dissolved in the synthetic amniotic fluid. Theadministrations of the study solution were started 3 days after the birth andwere continued for 3 weeks (21 days). The infants in the study groups werefollowed up until discharge and the frequency of NEC, mortality, and othercomplications of the disease among the groups were compared. The mortalityrate in preterm infants of the amniotic fluid and EPO groups were significantlylower than in the control group (p=0.027). We couldn’t find any significantdifferences in the frequency of NEC and other complications among the threestudy groups. The administration of synthetic amniotic fluid (with or withoutEPO) in preterm infants may decrease the mortality rate. Use of EPO insynthetic amniotic fluid did not affect the frequency of NEC.