Evidence map›Paper›PMID 39254979›Full record

Observational studyJAMA network open2024

Early High-Dose Erythropoietin and Cognitive Functions of School-Aged Children Born Very Preterm.

Flavia Maria Wehrle, Ulrike Held, Vera Disselhoff, Barbara Schnider, Alexandra Stöckli, Mina Toma, Hans Ulrich Bucher, Jean-Claude Fauchère, Giancarlo Natalucci, Petra Hüppi and 5 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Flavia Maria WehrleChild Development Center, University Children's Hospital Zurich, Zurich, Switzerland.
Ulrike HeldDepartment of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Vera DisselhoffDepartment of Neonatology and Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.
Barbara SchniderDepartment of Neonatology and Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.
Alexandra StöckliDepartment of Neonatology and Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.
Mina TomaDepartment of Neonatology and Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.
Hans Ulrich BucherNewborn Research, Department of Neonatology, University Hospital Zurich, Zurich, Switzerland.
Jean-Claude FauchèreNewborn Research, Department of Neonatology, University Hospital Zurich, Zurich, Switzerland.
Giancarlo NatalucciNewborn Research, Department of Neonatology, University Hospital Zurich, Zurich, Switzerland.
Petra HüppiDivision of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
Cristina Borradori-TolsaDivision of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
Maria Chiara LiveraniDivision of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
Ruth L O'GormanUniversity of Zurich, Zurich, Switzerland.
Beatrice LatalChild Development Center, University Children's Hospital Zurich, Zurich, Switzerland.
Cornelia Franziska HagmannDepartment of Neonatology and Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Children born very preterm are at risk for long-term neurodevelopmental sequelae. Prophylactic high-dose recombinant human erythropoietin (rhEpo) shortly after birth has not been shown to improve cognitive, motor, and behavioral development at 2 and 5 years. Objective: To investigate whether early high-dose rhEpo is associated with better executive functions and processing speed-late-maturing cognitive functions-in school-aged children born very preterm. Design, Setting, and Participants: This single-center cohort study was a prospective, observational follow-up study of a multicenter neonatal clinical trial; 365 children born very preterm (mean gestational age, 29.3 weeks [range, 26.0-31.9 weeks]) who had been enrolled in the Swiss EPO Neuroprotection Trial at birth between 2005 and 2012, and who were included in the primary outcome analyses at 2 years, were eligible to be recruited for the EpoKids study between 2017 and 2021 when they were at school age. Term-born children were additionally recruited and included in a control group. Data were analyzed between May and September 2022. Exposure: Administration of rhEpo (3000 IU/kg) or placebo (saline, 0.9%) intravenously 3 times within the first 2 days of life as part of the Swiss EPO Neuroprotection Trial. Main Outcome and Measures: A comprehensive neuropsychological test battery assessed executive functions and processing speed, and parents reported on their child's executive functions in everyday life to test the hypothesis that early high-dose rhEpo administration is associated with better cognitive outcomes at school age. Results: In the EpoKids study, 214 children born very preterm (58.6% of 365 children in eligible cohort) were assessed at a mean age of 10.4 years (range, 6.9-13.4 years); 117 (54.7%) were boys. There was no evidence that the 117 children who had received rhEpo differed from the 97 children who had received placebo in any of the 15 executive function and processing speed tests, nor in parent-rated executive functions (estimates ranged from -0.138 to 0.084, all 95% CIs included 0). Irrespective of rhEpo or placebo allocation, children born very preterm scored lower on 11 of 15 executive function and processing speed tests than term-born peers (estimates ranged from 0.112 to 0.255, 95% CIs did not include 0). Conclusion and Relevance: This study found no evidence for a positive association between prophylactic early high-dose rhEpo administration and long-term neurodevelopmental outcomes after very preterm birth. These results suggest that a comprehensive approach, including pharmacological and nonpharmacological prevention and intervention strategies, is needed to support these children's neurodevelopmental outcome.

Indexed as

CognitionErythropoietinInfant, Extremely PrematureChildChild, PreschoolDose-Response Relationship, DrugExecutive FunctionFemaleFollow-Up StudiesHumansInfant, NewbornMaleProspective StudiesRecombinant ProteinsErythropoietinRecombinant Proteins

Identifiers

PMID39254979
PMCPMC11388032

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.