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Efficacy of recombinant erythropoietin for the late treatment of anemia of prematurity in a level IV neonatal intensive care unit: a retrospective single-center cohort study



To describe the population to which we administered recombinant erythropoietin and to determine the effectiveness of this treatment as quantified by the change in hematocrit.

Study design

This retrospective chart review study included infants who received erythropoietin for the treatment of anemia of prematurity.


There were 132 infants representing 162 unique treatment courses included in the study. The average duration of therapy was 9 days (±7) and 6 doses (±2). The average change in hematocrit (Hct) was 6.2% (SD 3.9%, p < 0.001). Rise in Hct was associated with a higher number of rEPO doses (p < 0.001) and higher postmenstrual age (p < 0.001). In our small cohort we did not find an association between the number of rEPO doses and retinopathy of prematurity (ROP) requiring treatment.


Erythropoietin is safe and effective at treating anemia of prematurity as evidenced by a clinically and statistically significant increase in Hct from baseline.

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Fig. 1: Flowchart of courses reviewed, analyzed, and excluded.
Fig. 2: Individual response to rEPO was highly variable.
Fig. 3: Rise in hematocrit increases as the number of rEPO doses increases (p < 0.005).
Fig. 4: Rise in hematocrit increase with the number of days of rEPO therapy (p < 0.005).
Fig. 5: Higher PMA at the start of treatment was associated with a higher rise in hematocrit (p < 0.005).

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


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M. David Gothard, BS, MS of BioStats of Ohio, Inc. for his support in statistical analysis and power calculations.

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Authors and Affiliations



JC was responsible for literature review, project design, data collection, manuscript composition. JDM and JLM were responsible for project design, literature review, manuscript review. RMR was responsible for project design, literature review, data analysis, manuscript review. MLN was responsible for literature review and manuscript review. MN, RD and AS were responsible for literature review.

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Correspondence to Jillian M. Connolly.

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The authors declare no competing interests.

Ethics Approval and Consent to Participate

The protocol for this study was approved by the University Hospitals institutional review board. The need for informed consent was waived due to the retrospective nature of the study. This study was performed in accordance with the Declaration of Helsinki.

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Connolly, J.M., McClary, J.D., Desai, R. et al. Efficacy of recombinant erythropoietin for the late treatment of anemia of prematurity in a level IV neonatal intensive care unit: a retrospective single-center cohort study. J Perinatol 44, 892–896 (2024).

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