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Associate Professor, Department of Pediatrics, Division of Neonatology, University of Washington, Seattle, WA
Professor and Chairman, Department of Pediatrics, University of South Florida, St. Petersburg, FL
Reprints: Sandra E Juul MD PhD, Department of Pediatrics, Division of Neonatology, University of Washington, PO Box 356320, Seattle, WA 98195-6320, FAX 425/543-8926, E-mail sjuul{at}u.washington.edu
BACKGROUND: Erythropoietin (EPO) is present in amniotic fluid, colostrum, and human milk. One possible function of ingested EPO might be to stimulate erythropoiesis. However, it is unclear whether human neonates absorb recombinant human erythropoietin (rhEPO) after oral administration.
OBJECTIVE: To determine whether circulating EPO concentrations increase following enteral administration of rhEPO to neonates.
METHODS: The study was designed as a 2-center
prospective, blinded, randomized, 2 x 2 crossover study, with each
infant receiving 1 dose of rhEPO 1000 units/kg and 1 dose of placebo. Serum
EPO concentrations were measured at baseline, 2, and 4 hours following study
drug administration. The rhEPO and placebo dosing were separated by a mean of
72 hours. Analysis was stratified by gestational age (
35 wk, >35 wk)
and feeding type (human milk, infant formula).
RESULTS: No significant change in serum EPO concentration was identified at 2 or 4 hours following enteral administration of rhEPO.
CONCLUSIONS: Enteral administration of a large dose of rhEPO to neonates <4 months of age did not result in increased circulating EPO concentrations at 2 or 4 hours following dosing, regardless of whether it was administered in human milk or infant formula.
Key Words: enteral absorption, erythropoiesis, erythropoietin
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