Department of Pediatrics, Kaiser Permanente Los Angeles, United States of America.
Department of Pediatrics, Kaiser Permanente Los Angeles, United States of America.
Early Hum Dev. 2019 Oct;137:104831. doi: 10.1016/j.earlhumdev.2019.104831. Epub 2019 Jul 30.
Erythropoietin treatment is associated with a reduction in moderate to severe bronchopulmonary dysplasia in preterm infants. A regional retrospective study.
To determine whether premature infants treated with erythropoietin (Epo) in the neonatal period for anemia had a lower incidence of bronchopulmonary dysplasia (BPD), defined as oxygen need at 36 weeks postmenstrual age, and lower rehospitalization rates in the first year of life than infants not exposed.
Retrospective study of a population of infants born at 23 to 32 weeks gestational age, between January 2009 and December 2014, with birthweight ≤1500 g. Patient characteristics, and risk factors for BPD were compared between patients who received erythropoietin, and those not exposed. To examine the association between the outcomes of BPD at 36 weeks PMA, rehospitalization, and erythropoietin treatment, we performed a propensity score (PS) analysis using inverse probability of treatment weighted (IPTW) approach. For comparison, we conducted a logistic regression adjusting for the same covariates used to generate PS using the original population.
The study population included 1821 preterm infants: 928 received Epo and 893 did not. Epo treatment was associated with a reduction in BPD (18.8% versus 25.9%, p < 0.01) at 36 weeks PMA and reduced median length of stay with lowest BPD rate with Epo initiation before 2 weeks of age. There was no difference in rehospitalization rates in the first year of life.
Erythropoietin treatment was associated with a reduction in BPD but not in rehospitalization rate in the first year of life.
促红细胞生成素治疗与早产儿中中重度支气管肺发育不良的减少有关。一项区域性回顾性研究。
确定在新生儿期因贫血接受促红细胞生成素(Epo)治疗的早产儿是否患有支气管肺发育不良(BPD),定义为出生后 36 周时需要吸氧,以及在生命的第一年再入院率低于未暴露的婴儿。
对 2009 年 1 月至 2014 年 12 月出生于 23 至 32 周胎龄、出生体重≤1500g 的婴儿进行回顾性研究。比较接受促红细胞生成素治疗和未暴露的婴儿患者特征和 BPD 危险因素。为了检查 36 周 PMA 时 BPD、再入院和促红细胞生成素治疗的结果之间的关联,我们使用逆概率治疗加权(IPTW)方法进行倾向评分(PS)分析。为了比较,我们使用原始人群中用于生成 PS 的相同协变量进行了逻辑回归调整。
研究人群包括 1821 名早产儿:928 名接受 Epo 治疗,893 名未接受 Epo 治疗。Epo 治疗与 36 周 PMA 时 BPD(18.8%对 25.9%,p<0.01)的减少以及 Epo 起始于 2 周龄前与最低 BPD 率相关的中位住院时间缩短有关。第一年的再入院率没有差异。
促红细胞生成素治疗与 BPD 减少相关,但与第一年的再入院率无关。