Supplemental Iron and Recombinant Erythropoietin for Anemia in Infants Born Very Preterm: A Survey of Clinical Practice in Europe
Year: 2024
Type: supplementary-materials
Abstract: OBJECTIVES: To survey practices of iron and recombinant human erythropoietin (rhEpo) administration to infants born preterm across Europe. STUDY DESIGN: Over a 3-month period, we conducted an online survey in 597 neonatal intensive care units (NICUs) of 18 European countries treating infants born with a gestational age of <32 weeks. RESULTS: We included 343 NICUs (response rate 56.3%) in the survey. Almost all NICUs (97.7%) routinely supplement enteral iron, and 74.3% of respondents to all infants born <32 weeks of gestation. We found that 65.3% of NICUs routinely evaluate erythropoiesis and iron parameters beyond day 28 after birth. Most NICUs initiate iron supplementation at postnatal age of 2 weeks and stop after 6 months (34.3%) or 12 months (34.3%). Routine use of rhEpo was reported in 22.2% of NICUs, and in individual cases in 6.9%. RhEpo was mostly administered subcutaneously (70.1%) and most frequently at a dose of 250 U/kg 3 times a week (44.3%), but the dose varied greatly between centers. CONCLUSIONS: This survey highlights wide heterogeneity in evaluating erythropoietic activity and iron deficiency in infants born preterm. Variation in iron supplementation during infancy likely reflects an inadequate evidence base. Current evidence on the efficacy and safety profile of rhEpo is only poorly translated into clinical practice. This survey demonstrates a need for standards to optimize patient blood management in anemia of prematurity.
Source: The Journal of Pediatrics
Authors: Nora J. Reibel-Georgi, Alexandra Scrivens, Lisanne E. Heeger, Enrico Lopriore, Helen V. New, Emöke Deschmann, Simon J. Stanworth, Marta Aguar Carrascosa, Kristin Brække, Francesco Cardona, Filip Cools, Ryan Farrugia, Stefano Ghirardello, Jana Lozar Krivec, Katarina Matasova, Tobias Muehlbacher, Ulla Sankilampi, Henrique Soares, Miklós Szabó, Tomasz Szczapa, Gabriela Zaharie, Charles Christoph Roehr, Suzanne Fustolo-Gunnink, Christof Dame
Institutions: Charité - Universitätsmedizin Berlin, Oxford University Hospitals NHS Trust, Leiden University Medical Center, Sanquin, Willem-Alexander Kinderziekenhuis, National Health Service, Karolinska University Hospital, Karolinska Institutet, NHS Blood and Transplant, Hospital Universitari i Politècnic La Fe, Oslo University Hospital, Medical University of Vienna, Universitair Ziekenhuis Brussel, Mater Dei Hospital, Policlinico San Matteo Fondazione, Ljubljana University Medical Centre, Martin University Hospital, University Hospital Zurich, University of Eastern Finland, Kuopio University Hospital, Hospital de São João, Semmelweis University, Poznan University of Medical Sciences, Iuliu Hațieganu University of Medicine and Pharmacy, North Bristol NHS Trust, Southmead Hospital, University of Bristol, University of Oxford, Amsterdam University Medical Centers
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,320
OpenAlex ID: W4402528020