EFFECT OF ERYTHROPOIETIN ON PREVENTION OF CEREBRAL PALSY IN HYPOXIC ISCHEMIC ENCEPHALOPATHY Study of hemoglobin, C-reactive protein, Caspase-3 and Tumor Necrosing Factor-- levels Fadhilah Tia Nur1*, Harsono Salimo1, Hardiono D Pusponegoro2, Ari Natalia Probandari3, Bambang Purwanto4, and Soetrisno5
1Department of Child Health, Medical Faculty, Sebelas Maret University, Indonesia
2Department of Child Health, Medical Faculty, University of Indonesia, Indonesia
3Department of Public Health, Medical Faculty, Sebelas Maret University, Indonesia
4Department of Internal Medicine, Medical Faculty, Sebelas Maret University, Indonesia
5Department of Obstetric and Gynecology, Medical Faculty, Sebelas Maret University, Indonesia
*fadhilah.harris[at]gmail.com
Abstract
ABSTRACT
Hypoxic ischemic encephalopathy (HIE) is one of the leading causes of cerebral palsy (CP) and neonatal mortality in developing countries. Erythropetin (Epo) is one of the newest neuroprotective therapies to prevent cerebral palsy. In order to analyze the effect of Epo as neuroprotective agent to prevent CP, a double-blind, randomized, placebo-controlled trial was conducted between January-October 2022 in neonatology ward, at a tertiary hospital in Surakarta, Indonesia. We assigned 25 infants borned at 32 weeks or more of gestation with HIE based on Thompson^s criteria to receive Epo or placebo. Epo (1000 IU per kilogram of body weight) or saline placebo was administered intravenously within 24 hours after birth, as well as at 2, 3, 4, and 5 days of age. Before and after treatment, hemoglobin, c-reactive protein (CRP), caspase-3 and tumor necrosing factor-- (TNF--) levels were checked. Neurological examination was performed at 2, 4, and 6 months of age to assess the occurrence of CP. There was an effect of Epo administration on hemoglobin and caspase-3 levels, but there was no difference in erythropetin administration on CRP and TNF-- levels. There was no significant difference in the occurrence of cerebral palsy in the treatment group. Epo has significant neuroprotective effects on caspase-3 levels, but this is not enough to prevent CP.
