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The Effects of Recombinant Human Erythropoietin Given Immediately After Delivery to Women With Anaemia


from Current Medical Research and Opinion
Posted 07/23/2003

T. Hatzis, E. Cardamakis, V. Tsapanos, G. Kourounis, N. Linardos, H. Mantouvalos, V. Tzingounis



Summary and Introduction
Summary

Objective: Anaemia is a common problem during pregnancy and the puerperium. This study was designed to determine the efficacy and safety of giving recombinant human erythropoietin (EPO) to anaemic women during the puerperium.

Method: Thirty-seven women received a single dose of EPO (20 000 IU intravenously) immediately after delivery. A control population (n = 37) matched according to age and haemoglobin concentration was evaluated. All women received oral iron supplementation for 40 days after delivery. Haemoglobin concentrations were measured 4 and 40 days after delivery. Blood transfusions were given depending on clinical condition and haemoglobin level.

Results: Patients treated with EPO had a significantly higher mean haemoglobin concentration than control patients at days 4 and 40. No women in the EPO group required a transfusion, compared with six in the control group. No side-effects and fewer anaemia-related symptoms were observed during EPO treatment.

Conclusion: EPO given at delivery is effective in decreasing the need for blood transfusion and the incidence of problems associated with anaemia during the puerperium.

Introduction
Anaemia during pregnancy and in the puerperium is common, and is associated with a range of symptoms and adverse effects in both the mother and foetus/infant[1]. This study was undertaken to determine the efficacy and safety of recombinant human erythropoietin (EPO) administration in otherwise healthy anaemic women during the puerperium in order to minimise the problems associated with severe anaemia and blood transfusions during this period.

Endogenous erythropoietin is a glycoprotein, produced mainly by the kidneys, which increases the number of developing proerythroblasts and enhances the release of reticulocytes from bone marrow. It is required for the viability, multiplication and differentiation of erythrocytes and their precursors[2,3].

Recombinant human erythropoietin (EPO) is widely used for the treatment of anaemia associated with renal insufficiency[4] and cancer[5]. The administration of EPO (300-600 IU/kg 3 to 4 times per week) has been shown to increase reticulocyte counts in patients awaiting hip replacement[6] and to raise the haematocrit in patients with anaemia associated with rheumatoid arthritis[7]. Several studies have shown that EPO is a safe alternative to blood transfusion and is effective in reducing anaemia in many conditions.



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T. Hatzis1, E. Cardamakis2, V. Tsapanos2, G. Kourounis2, N. Linardos3, H. Mantouvalos3 and V. Tzingounis2

1Department of Hematology,'Mitera' Maternity and Surgical Center, Athens,
2Department of Obstetrics and Gynecology, University of Patras, Rion, Greece
3Department of Obstetrics and Gynecology, 'Mitera' Maternity and Surgical Center, Athens, Greece



Curr Med Res Opin 19(4):346-349, 2003. © 2003 Librapharm Limited

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