الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Necrotizing enterocolitis (NEC) an inflammatory bowel disease of newborn infants attributed to multifactorial etiology often presents unexpectedly in the Neonatal Intensive Care Unit. It is the commonest gastrointestinal emergency with high morbidity and mortality, particularly in extremely premature infants.(30) The overall incidence of NEC is approximately 1 in 1000 live births, but in infants less than 1500 g, the incidence increases to between 3% and 10%. Multiple risk factors including prematurity, timing of initiation, composition and rate of enteral feeding, bacterial infection and intestinal ischemia have been implicated in the pathogenesis of NEC.(37)
There is no definitive curative treatment for NEC, many scopes of treatment are widely investigated one of these investigated lines is the use of hematopoietic factors to improve NEC especially erythropoietin (EPO), based on the finding that fetus swallows amniotic fluid which contains several growth factors that are also present in breast milk(14), EPO given enterally is believed to affect the growth of villi and crypts (21),decreases the inflammatory mediators in the gastrointestinal tract resisting injury(17), and also protects the intestinal barrier function leading to that it might be a novel drug that might decrease the incidence of NEC.(43)
The aim of this longitudinal prospective double blinded controlled study is to evaluate the effects of enteral administration of recombinant human erythropoietin (rh EPO) in preterm infants born 32 weeks of gestation or less and aims to determine whether oral erythropoietin decreases feeding intolerance in preterm newborn, and also its prophylactic effect against NEC.
This study was conducted at the neonatal intensive care unit at Alexandria University Maternity Hospital One hundred twenty preterm neonate born less than or equal 32 weeks gestational age admitted to the intensive care unit in the period from July 2015 to January 2016 randomly divided into two equal groups of 60 preterm infants :EPO group and placebo group where 63 patient dropped from both groups due to either the intake of enteral hematopoietic growth factor intravenous immunoglobulin or due to their early death before the completion of the drug treatment days, 57 preterm infants remained after the exclusion:32 preterm infants in the EPO group and 25 preterm infants in the placebo group.
Every baby in this study was evaluated as regards:
Day of successful start of enteral feeding, times to establish one-half, two-thirds, and full enteral feedings after drug/placebo administration, number of episodes of feeding intolerance, number of days feeding were withheld due to feeding intolerance, time to regain birth weight, the incidence of NEC, growth parameters expressed as weight, length and head circumference percentile.
The findings of this study were as follows:
There were no significant difference between the EPO treated group and the placebo group as regards the number of episodes of feeding intolerance and the NEC incidence.
No noted differe