Preschool Assessment of Preterm Infants Treated With Darbepoetin and Erythropoietin.

Autor:	Ohls RK; Departments of Pediatrics, rohls@salud.unm.edu., Cannon DC; Internal Medicine., Phillips J; Neurology., Caprihan A; Mind Research Network, Albuquerque, New Mexico;, Patel S; Department of Pediatrics and., Winter S; Department of Pediatrics and., Steffen M; Utah State Department of Health, Salt Lake City, Utah., Yeo RA; Psychology, and., Campbell R; Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, New Mexico;, Wiedmeier S; Department of Pediatrics and., Baker S; Center for Clinical and Translational Science, University of Utah, Salt Lake City, Utah; and., Gonzales S; Mind Research Network, Albuquerque, New Mexico;, Lowe J; Departments of Pediatrics.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2016 Mar; Vol. 137 (3), pp. e20153859. Date of Electronic Publication: 2016 Feb 15.
DOI:	10.1542/peds.2015-3859
Abstrakt:	Background: We previously reported improved neurodevelopmental outcomes at 2 years among infants treated with the erythropoiesis-stimulating agents (ESAs) darbepoetin alfa (darbepoetin) or erythropoietin. Here we characterize 4-year outcomes. Methods: Former preterm infants randomly assigned to receive darbepoetin (10 μg/kg, once per week), erythropoietin (400 U/kg, 3 times/week), or placebo through 35 weeks' postconceptual age were evaluated at 3.5 to 4 years of age. For comparison, healthy children formerly delivered full term (term controls [TCs]) were also recruited. All participants were assessed by using measures of full-scale IQ (FSIQ) and general language from the Wechsler Preschool and Primary Scale of Intelligence, Third Edition, and an overall measure of executive function, on the basis of tests evaluating inhibitory control and spatial working memory. Rates of neurodevelopmental impairment were compared across groups. Results: Multivariate analysis of variance compared children randomly assigned to ESAs (n = 39), placebo (n =14), and TCs (n = 24). FSIQ and performance IQ were significantly higher in the ESA group than in the placebo group (FSIQ: 91.1 ± 17.5 vs 79.2 ± 18.5, P = .036; performance IQ: 93.0 ± 17.0 vs 79.5 ± 19.5, P = .018). Follow-up analyses revealed that the children receiving ESAs performed better than those who received placebo on executive function tasks. The ESA group's performance was below that of TCs, but the results did not reach significance on executive function. The incidence of neurodevelopmental impairment was greater in the placebo group than in the ESA group. Conclusions: ESA-treated infants had better cognitive outcomes and less developmental impairment at 3.5 to 4 years of age compared with placebo-treated infants. ESAs show promise in improving long-term cognitive outcomes of infants born prematurely. (Copyright © 2016 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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