Lack of relationship between cord blood erythropoietin and intraventricular hemorrhage in premature neonates: a controversial result
The aim of this study was to assess the incidence and risk factors of intraventricular hemorrhage (IVH) as well as the role of cord blood erythropoietin (EPO) level in predicting the possibility of IVH in premature neonates.
Materials and methods
This prospective study included 140 preterm neonates born at hospitals affiliated to Shiraz University of Medical Sciences from May 2014 to April 2015. Complete blood count and cord blood EPO level was measured after birth. Brain ultrasonography was performed at 3 and 7–10 days after birth in these newborns.
Brain ultrasonography showed IVH in 8.57% (12/140) until the third day and 20% (28/140) at 7–10 days of life in premature neonates. Early gestational age, low birth weight, low Apgar score, and failure to give prenatal steroid were significant risk factors for developing IVH. The mean level of cord blood EPO was 20.95 ± 21.09 mIU/mL in premature newborns without IVH and 15.82 ± 17.11 mIU/mL with IVH. There was no correlation between the cord blood EPO and IVH in premature newborns.
Antenatal steroids therapy should be encouraged among women at risk of premature delivery. Our results showed that the cord blood EPO was not correlated with IVH in preterm neonates and further research is required to assess this relationship.
KeywordsPremature Intraventricular hemorrhage Erythropoietin Risk factors
We are thankful to all the parents who took part in this study. The authors would like to thank Shiraz University of Medical Sciences, Shiraz, Iran and also Center for Development of Clinical Research of Nemazee Hospital and Dr. Nasrin Shokrpour for editorial assistance.
Najib Kh contributed to the conception, design, and analysis the data and wrote the paper; Hashemi Z and Pishva N contributed to the design of the research study and analysis of data; Moghtaderi M contributed to the statistical analysis of the data, drafting and writing the article; Pishdad P performed the brain sonography and writing; and Najib Fs examined the newborns and wrote the article. Each author contributed to revisions of the manuscript and approval of the final version.
This work was supported by a grant from Shiraz University of Medical Sciences (7369-21-01-93).
Compliance with ethical standards
Conflict of interest
No conflict of interest is declared.
- 9.Khodapanahandeh F, Khosravi N, Larijani T (2008) Risk factors for intraventricular hemorrhage in very low birth weight infants in Tehran, Iran. Turk J Pediatr 50(3):247–252Google Scholar
- 19.Khosravi N, Badamchi A, Khalesi N, Tabatabaee A, Naghdalipour M, Asgarian R (2017) Measurement of interleukin-6 (IL-6) and erythropoietin (EPO) in umbilical cords of preterm infants with intraventricular hemorrhage in two hospitals in Tehran. J Matern Fetal Neonatal Med 30(15):1847–1850CrossRefGoogle Scholar
- 20.Ment LR, Ådén U, Bauer CR, Bada HS, Carlo WA, Kaiser JR, Lin A, Cotten CM, Murray J, Page G, Hallman M, Lifton RP, Zhang H, Gene Targets for IVH Study Group and the Neonatal Research Network (2015) Genes and environment in neonatal intraventricular hemorrhage. Semin Perinatol 39(8):592–603CrossRefGoogle Scholar
- 22.Gleissner M, Jorch G, Avenarius S (2000) Risk factors for intraventricular hemorrhage in a birth cohort of 3721 premature infants. J Perinat Med 28(2):104–110Google Scholar
- 28.Elimian A, Verma U, Canterino J, Shah J, Visintainer P, Tejani N (1999) Effectiveness of antenatal steroids in obstetric subgroups. Obstet Gynecol 93(2):174–179Google Scholar
- 32.Humberg A, Härtel C, Paul P, Hanke K, Bossung V, Hartz A, Fasel L, Rausch TK, Rody A, Herting E, Göpel W, German Neonatal Network (GNN) (2017) Delivery mode and intraventricular hemorrhage risk in very-low-birth-weight infants: observational data of the German Neonatal Network. Eur J Obstet Gynecol Reprod Biol 212:144–149CrossRefGoogle Scholar
- 33.Chen Y, Zou L, Li G, Ruan Y, Wang X, Zhang W (2015) Appropriate delivery mode and timing of termination for pregnancy with low birth weight infants. Zhonghua Fu Chan Ke Za Zhi 50(5):323–328Google Scholar
- 37.Sajjadian N, Fakhrai H, Jahadi R (2010) Incidence of intraventricular hemorrhage and post hemorrhagic hydrocephalus in preterm infants. Acta Med Iran 48(4):260–262Google Scholar