Agen Stimulasi Eritropoiesis pada Bayi Prematur

Oleh :

dr. Utari Nur Alifah

Bayi prematur sering memerlukan agen stimulasi eritropoiesis karena mengalami anemia dan memiliki kadar eritropoetin yang rendah. Anemia pada bayi prematur memiliki dampak jangka panjang pada tumbuh kembang. Pengambilan darah berulang-ulang, masa hidup sel darah merah yang lebih pendek, dan respons lemah terhadap eritropoetin berkontribusi terhadap kejadian anemia pada bayi prematur.[1,2]

Normalnya, bayi baru lahir yang cukup bulan mengalami penurunan hemoglobin hingga 11g/dL di usia 8-12 minggu. Pada bayi prematur, penurunan dapat mencapai 7,0 hingga 10,0 g/dL di usia 6 minggu.[2]

Bayi prematur dengan berat badan lahir sangat rendah memiliki risiko tinggi terhadap morbiditas dan mortalitas. Kelompok ini seringkali memerlukan transfusi sel darah merah di minggu-minggu pertama kehidupannya karena mempertahankan kadar besi dan hemoglobin pada bayi baru lahir sangat penting untuk mendukung eritropoiesis, pertumbuhan, dan perkembangan otak.[3]

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Cibulskis, C.C., Maheshwari, A., Rao, R. et al. Anemia of prematurity: how low is too low?. J Perinatol, 2021. 41, 1244–1257. https://doi.org/10.1038/s41372-021-00992-0
2. Ohlsson A, Aher SM. Early erythropoiesis-stimulating agents in preterm or low birth weight infants. Cochrane Database Syst Rev. 2020 Feb 11;2(2):CD004863. doi: 10.1002/14651858.CD004863.pub6.
3. Rocha G, Pereira S, Antunes-Sarmento J, et al. Early anemia and neonatal morbidity in extremely low birth-weight preterm infants. The Journal of Maternal-Fetal & Neonatal Medicine, 2021. 34(22), 3697–3703. https://doi.org/10.1080/14767058.2019.1689948
4. Alexis L, Vijay G. Molecular and cellular mechanisms that regulate human erythropoiesis. Blood 2022; 139 (16): 2450–2459. doi: https://doi.org/10.1182/blood.2021011044
5. Tang P, Wang H. Regulation of erythropoiesis: emerging concepts and therapeutic implications. Hematology. 2023; 28(1):2250645.
6. Fahim NM, Georgieff MK, Zhang L, Naisbitt S, Rao RB, Inder TE. Endogenous erythropoietin concentrations and association with retinopathy of prematurity and brain injury in preterm infants. Plos one. 2021 Jun 2;16(6):e0252655.
7. Mah EM, Tague DA, Yondjeu OJ, Nkwelle IM, Nengom JT, Meguieze CA. Determinants of anemia in premature newborns and the immediate outcome at the Mother and Child Center of the Chantal BIYA Foundation, Cameroon. J Med Res. 2021;7(5):146-9.
8. Chaudhary N, Jassar R, Singh R. Neonatal anemia. Newborn. 2022;1:263-70. https://www.newbornjournal.org/doi/JNB/pdf/10.5005/jp-journals-11002-0027
9. Qin N, Qin H. Efficacy and safety of high and low dose recombinant human erythropoietin on neurodevelopment of premature infants: A meta-analysis. Medicine. 2021; 100(18):e25805.
10. Wellmann S, Hagmann CF, von Felten S, Held L, Klebermass-Schrehof K, Truttmann AC, Knöpfli C, Fauchère JC, Bührer C, Bucher HU, Rüegger CM. Safety and Short-term Outcomes of High-Dose Erythropoietin in Preterm Infants With Intraventricular Hemorrhage: The EpoRepair Randomized Clinical Trial. JAMA Network Open. 2022; 5(12):e2244744-.
11. Song J, Wang Y, Xu F, Sun H, Zhang X, Xia L, Zhang S, Li K, Peng X, Li B, Zhang Y. Erythropoietin improves poor outcomes in preterm infants with intraventricular hemorrhage. CNS drugs. 2021; 35(6):681-90.
12. Sun H, Song J, Kang W, et al. Effect of early prophylactic low-dose recombinant human erythropoietin on retinopathy of prematurity in very preterm infants. J Transl Med, 2020. 18, 397. https://doi.org/10.1186/s12967-020-02562-y
13. Perrone S, Lembo C, Gironi F, Petrolini C, Catalucci T, Corbo G, Buonocore G, Gitto E, Esposito SM. Erythropoietin as a neuroprotective drug for newborn infants: Ten years after the first use. Antioxidants. 2022 Mar 28;11(4):652.