Objective To identify the effect of early parentral recombinant human erythropoietin (r-HuEPO) and iron administration on blood transfusion requirement of premature infants.

Methods In a controlled clinical trial conducted at the Neonatal Intensive Care Unit, Al-Hada Military Hospital, Taif, Kingdom of Saudi Arabia over a 16 month period, we assigned 20 very low birth weight infants (VLBW) with mean (±SEM) gestational age of 28.4±0.5 weeks and mean (±SEM) birth weight of 1031±42 g, to receive either intravenous r-HuEPO 200 U/kg/day and iron 1 mg/kg/day or conventional therapy over a 21 day study period. Blood transfusion administration undergoes a strict protocol in our nursery.

Results During the three week study period, the hemoglobin and heamatocrit remained similar in the two groups while the reticulocyte counts were greater in the r-HuEPO recipients on day 14. The number and volume of blood transfusions were similar in both groups.

Conclusion VLBW infants receive fewer blood transfusions than the number previously reported. Strict phlebotomy and transfusion criteria could minimize the need for r-HuEPO.