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Effect of Administering Recombinant Erythropoietin to Women with Postpartum Anemia: A Meta-analysis

Journal of Perinatology volume 24, pages 11–15 (2004)Cite this article

Abstract

OBJECTIVES: Recombinant erythropoietin (rEpo) has been administered to women with postpartum anemia in an attempt to accelerate their increase in hemoglobin concentration and reduce postpartum transfusions. However, it is not clear whether such an approach can be supported by evidence and should be generally recommended.

STUDY DESIGN AND METHODS: Medical and scientific literature from January 1990 to December 2002 was searched and studies that reported the administration of rEpo to women with postpartum anemia were evaluated.

RESULTS: Eight evaluated studies reported an aggregate of 480 women; 300 rEpo recipients and 180 controls. Significant diversity in design was observed in rEpo dose, route of rEpo administration, iron supplementation, and baseline hemoglobin. No significant safety concerns were reported. In all five studies where it was reported, 4 to 7 days after beginning treatment, greater increases in hemoglobin concentration were observed among the rEpo recipients than among the controls. However, heterogeneity of results (Q-test statistic, p<0.01) indicated that it was not appropriate to apply summary statistics. The effect of rEpo on postpartum transfusion rate was not measurable by summary statistics because of the limited number of transfusions given (no transfusions among the 300 rEpo recipients vs two transfusions among the 180 controls).

CONCLUSION: Administration of rEpo to women with postpartum anemia appears to be safe, and is associated with a trend toward a faster increase in hemoglobin concentration. However, its efficacy in terms of diminishing postpartum transfusions is unproven.

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Author notes

  1. Robert D Christensen: R.D.C was supported by Grants HL-61798, HD-69990 and HD-42308.

  2. Darlene A Calhoun: D.A.C. was supported by Grants HD-01180 and HD-42326 from the National Institutes of Health.

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of South Florida College of Medicine, All Children's Hospital, St. Petersburg, FL, USA

    Anne C Kotto-Kome MD, Darlene A Calhoun DO, Roberto Sosa MD & Robert D Christensen MD

  2. Division of Maternal-Fetal Medicine, Bayfront Medical Center, St. Petersburg, FL, USA

    Raul Montenegro MD

  3. Division of General Pediatrics, University of South Florida College of Medicine, Tampa, FL, USA

    Luis Maldonado MD, MPH

Authors
  1. Anne C Kotto-Kome MD
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  2. Darlene A Calhoun DO
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  3. Raul Montenegro MD
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  4. Roberto Sosa MD
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  5. Luis Maldonado MD, MPH
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  6. Robert D Christensen MD
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Kotto-Kome, A., Calhoun, D., Montenegro, R. et al. Effect of Administering Recombinant Erythropoietin to Women with Postpartum Anemia: A Meta-analysis. J Perinatol 24, 11–15 (2004). https://doi.org/10.1038/sj.jp.7211017

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