Question of the Week

Question

Question :

Posted On : 31 May 2026

Erythropoietin- is it a cost-effective tool in preventing AOP in our scenario? Does it confer some benefit? What is its dose and route of administration, and when should we start it?

Expert Answer :

Answer Discussion :

M

Michelle Spencer

0

5 Days ago

A

Anshumaan Agrahari

0

yes it's cost effective
dose @400iu/kg
sc/ im
day 2 of life

5 Days ago

Answer 1

As a primary prevention therapy for Anemia of Prematurity (AoP), Recombinant Erythropoietin (rEPO) has not been shown to be of any benefit. Many studies have shown that prophylactic rEPO by itself does not prevent AoP. At best, in some studies, it has resulted in a slight decrease in the need for late blood transfusions in preterm infants. Further, all of these studies included supplementing oral iron along with rEPO. However, I have yet to find any recommendation that suggests the use of rEPO as a preventive strategy for AoP. Certainly, in the subcontinent scenario, it is highly unlikely to have any cost benefit if at all any clinical benefit. As financial resources may be limited, I think they should be better utilised for other critical therapies like good and safe TPN, etc., which could prove beneficial in improving infant growth, leading to earlier discharge and thus reducing the cost of care. Special vaccination is another neglected area.
Most of the research and clinical experience shows that reducing iatrogenic blood loss by reducing the quantity of blood withdrawn and judicious planning of investigations has the maximum benefit. Use of microsampling methods and micro-containers seems to be quite logical. Further, supplementing oral iron to preterm infants by 3 weeks postnatal age, if they are medically stable and tolerating full oral feeding, seems to be quite effective and safe. Probably, this is the cheapest therapy one could offer to preterm babies. The usual dose is ~3 mg per kg per day. This could be continued for 3 - 4 months post-discharge.

Question of the Week

Home

Partner Sites