Clinical Trials for Preterm Infants' Neurodevelopment to the Norm: Erythropoietin and Nutritional Interventions

ABSTRACT

Although the incidence of severe intraventicular hemorrhage and cystic periventricular leukomalacia in preterm infants has significantly decreased, approximately 10–15% of preterm survivors demonstrate cerebral palsy and 50–80% of extremely preterm infants demonstrate mild-to-severe neurodevelopmental impairment. Compared to term infants, preterm infants show a higher incidence of brain damage secondary to hypoxic injury, inflammation, and malnutrition. Clinical trials have evaluated outcomes following early administration of high dose erythropoietin and nutritional interventions including early aggressive nutrition, human breast milk, and long-chain polyunsaturated fatty acids supplementation to prevent preterm infants' neurodevelopmental impairment and improve neurodevelopmental outcome. Further studies are warranted to investigate the safety, optimal dose, timing, duration with respect to erythropoietin and nutritional interventions, and the optimization of a target population of preterm infants suited for interventions.