Effect of short-term recombinant human erythropoietin therapy in the prevention of anemia of prematurity in very low birth weight neonates.

Premature infants especially those with birth weight < 1500 g suffer from Anaemia of prematurity (AOP) and associated problems. Erythropoietin therapy is a safe effective way to prevent and to treat anaemia of prematurity. To evaluate the effect of short-term administration of recombinant human erythropoietin (rHuEPO) with iron and folic acid in very low birth weight (VLBW) neonates in the prevention of anaemia of prematurity. A randomized controlled trial was carried out at Dhaka Shishu Hospital. Sixty preterm very low birth weight (PTVLBW) babies were enrolled in this study. Thirty were assigned to rHuEPO group and 30 as control. Baseline haematologic values were estimated before administration of rHuEPO. From day 7 of life rHuEPO-200 IU/kg/dose subcutaneously every alternate day for 2 weeks was administered to rHuEPO group. All infants in both groups have received oral iron, folic acid from day 14. Clinical and haematological assessment was done at 6 and 10 weeks of life. Baseline clinical characteristics and haematologic values were almost similar in both groups. This study has shown increase in haematological values (haemoglobin and haematocrit) and reduction in the number of blood transfusions during both the 1st and 2nd follow up in rHuEPO group in comparison to control group (p < 0.01). Short-term rHuEPO appears to be very effective in prevention of Anaemia of prematurity.

Effect of oral zinc supplementation on the growth of preterm infants.

OBJECTIVE: To compare the effect of oral zinc supplementation on growth of preterm infants. DESIGN: Randomized controlled trial. SETTING: Dhaka Shisu Hospital (Tertiary care hospital). SUBJECTS: 100 appropriate for date preterm infants weighing between 1000 to 2500 g were randomized to receive zinc and multivitamin supplement (Group I; n=50) or only multivitamin supplement (Group II). INTERVENTION: Zinc supplementation was given 2mg/kg/day for 6 weeks along with multivitamin in Group I and only multivitamin to Group II. PRIMARY OUTCOME VARIABLE: Increment of weight and length. RESULTS: At enrollment, serum zinc (62.1 ± 12.4 ug/dL in Group I and 63.1 ± 14.6 ug/dL in Group II) and hemoglobin levels (14.9 ± 2.4 g/dL in Group I and 14.4 ± 1.7 g/dL in Group II) were almost similar in both groups. Serum zinc levels were in lower limit of normal range. After supplementation, serum zinc and hemoglobin levels were significantly higher in Group I (105 ± 16.5 ug/dL) than Group II (82.2 ± 17.4 ug/dL) (P<0.05). Weight, length and head circumference were comparable in both groups at enrollment. Significant differences in weight gain and increment in length were found in first and second follow up between two groups but OFC increments were not significant (P>0.05). Reduction of morbidity was apparent in zinc supplemented group. No serious adverse effect was noted related to supplementation therapy. CONCLUSION: Zinc supplementation for preterm low birth weight babies is found effective to enhance the growth in early months of life.