Table 1 Is supplementary iron useful when preterm infants are treated with erythropoietin?
| First author, year, country | Patient group | Study type (level of evidence) | Outcome | Key results | Study weaknesses |
|---|---|---|---|---|---|
| Carnielli et al,1 1998, Italy | 63 preterm infants with birth weight ⩽1750 g and gestational age ⩽32 weeks were randomised to three groups: group 1 received 400 IU rHuEPO/kg, 3 times/week and 20 mg/kg/week of IV iron; group 2 received 400 IU rHuEPO/kg, 3 times/week; group 3 control | Individual double‐blind RCT (level 1b) | Number of transfusions | Fewer transfusions with those receiving IV iron | Quality score Jadad scale 3; the data in this study were difficult to interpret as mean data and logarithms of data were reported |
| Fujiu et al,2 2004, Japan | 24 preterm infants with birth weight 750–1499 g, postnatal age 14–28 days and Hb <12 g/dl were randomised to two groups: group 1 received 200 IU rHuEPO/kg twice weekly and 4 mg/kg/day oral iron; group 2 received 200 IU rHuEPO/kg twice weekly | Individual RCT (level 1b) | Number of transfusions | No transfusions given in either group | Quality score Jadad scale 2; methods of randomisation were not well described; the sample size was small, so the significance that could be attached to the findings of the study is uncertain |
| Kivivuori et al,3 1999, Finland | 41 preterm infants with birth weight <1500 g were randomised to three groups: group 1 received 300 IU rHuEPO/kg, 3 times/week and 6 mg/kg/day of oral iron; group 2 received 300 IU rHuEPO/kg, 3 times/week and 12 mg/kg/day of IM iron; group 3 received 12 mg/kg/day of IM iron | Multicentre RCT (level 1b) | Number of transfusions | No statistical difference between groups (p = 0.2) | Quality score Jadad scale 2; randomisation method was not well described |
| Meyer et al,4 1996, South Africa | 42 preterm infants with birth weight <1500 g, gestational age<33 weeks and postnatal age 7–30 days were randomised to two groups: group 1 received 600 IU rHuEPO/kg, 3 times/week and 6 mg/kg/week of IV iron; group 2 received 600 IU rHuEPO/kg, 3 times/week and 12 mg/kg/day of oral iron | Individual RCT (level 1b) | Number of transfusions | No difference between groups, concludes that oral iron is sufficient | Quality score Jadad scale 2; randomisation method was inadequately described |
| Bader et al,5 2001, Israel | 30 preterm infants with birth weight <1750 g, gestational age <34 weeks and postnatal age 3–5 weeks were randomised to two groups: group 1 received 900 µg rHuEPO/kg/week and 8 mg/kg/day of oral iron; group 2 received 900 µg rHuEPO/kg/week and 16 mg/kg/day of oral iron | Multicentre double‐blinded RCT (level 1b) | Number of transfusions | No significant difference between groups, concludes that oral iron is sufficient | Quality score Jadad scale 2; randomisation method was not well described |
| Nazir et al,6 2002, USA | 52 preterm infants with gestational age ⩽32 weeks and postnatal age >7 days were randomised to three groups: group 1 received 1200 IU rHuEPO/kg/week and 6 mg/kg/day of oral iron; group 2 received 1200 IU rHuEPO/kg/week and 12 mg/kg/day of oral iron | Individual double‐blinded RCT (level 1b) | Number of transfusions | No difference between the two groups | Quality score Jadad scale 5 |
Hb, haemoglobin; IM, intramuscular; IV, intravenous; rHuEPO, recombinant erythropoietin; RCT, randomised controlled trial.