Medication Summary

Prematurity is not a specific illness. Medications administered to an infant are prescribed for a specific purpose and are discussed in each of the articles mentioned previously about specific disease processes.

A 2013 study found that injections of the erythropoiesis-stimulating agent darbepoetin alfa (Darbe) may eliminate or reduce the need for red blood cell transfusions in preterm infants.^{[60, 61]}In the study, which included 102 preterm infants at four high-altitude medical centers, infants were randomized to treatment with erythropoietin (Epo) 400 U/kg, given subcutaneously thrice weekly; darbepoetin alfa 10 μg/kg, given subcutaneously once a week with sham dosing two other times a week; or placebo in three sham doses a week through 35 weeks' gestation, discharge, transfer to another hospital, or death. Doses were adjusted for body weight weekly.^{[60, 61]}

Infants in the darbepoetin alfa and erythropoietin groups received significantly fewer transfusions and had significantly fewer donor exposures than those in the placebo group, and 59% of the darbepoetin alfa-treated infants and 52% of the erythropoietin-treated infants received no transfusions at all, compared with 38% of infants in the placebo group. Compared with infants in the placebo group, darbepoetin alfa- and erythropoietin-treated infants had significantly higher changes in absolute reticulocyte counts and hematocrits.^{[60, 61]}Use of an erythropoiesis-stimulating agent can be helpful; however, the potential for neovascularization and tumor progression cannot be ignored.^[62]

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Media Gallery

Preterm infant at 28 weeks' gestation. Note the small amount of ear cartilage and/or flattened pinna.
Preterm infant at 33 weeks' gestation. Note the increased cartilage, recoil, and outer ridge curving inward.
A term infant has well-developed cartilage with instant recoil.
Preterm infant at 28 weeks' gestation. Note the flat sole.
Preterm infant at 33 weeks' gestation. Note the presence of only an anterior crease.
Term gestation. Note the multiple creases.
Preterm infant at 28 weeks' gestation. No breast tissue is present, and the areolae are barely visible.
Preterm infant at 33 weeks' gestation. The breast tissue is less than 1 cm, and the areolae are raised and/or pigmented.

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Author

Susan A Furdon, RNC, NNP-BC, MS Neonatal Clinical Nurse Specialist/Nurse Practitioner, Department of Pediatrics, Albany Medical Center

Susan A Furdon, RNC, NNP-BC, MS is a member of the following medical societies: National Association of Neonatal Nurses, Sigma Theta Tau International

Disclosure: Nothing to disclose.

Coauthor(s)

David A Clark, MD Professor and Martha Lepow Chairman of Pediatrics, Professor of Obstetrics and Gynecology, Albany Medical College; Director, Children's Hospital at Albany Medical Center

David A Clark, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Nutrition, American Forestry Association, American Pediatric Society, Capital District Pediatric Society, Christian Medical and Dental Associations, European Society for Paediatric Research, Eastern Society for Pediatric Research, Floyd W Denny Pediatric Alumni Society, Medical Society of the State of New York, New York Academy of Sciences, Society for Pediatric Research

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Arun K Pramanik, MD, DCH, FAAP, FIAP, FRCP Professor of Pediatrics, LSU Health, Louisiana State University School of Medicine in Shreveport

Arun K Pramanik, MD, DCH, FAAP, FIAP, FRCP is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society, National Perinatal Association, Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Dharmendra J Nimavat, MD, FAAP Associate Professor of Clinical Pediatrics, Department of Pediatrics, Division of Neonatology, Southern Illinois University School of Medicine; Staff Neonatologist, Clinical Director, NICU Regional Perinatal Center, HSHS St John's Children's Hospital

Dharmendra J Nimavat, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association of Physicians of Indian Origin

Disclosure: Nothing to disclose.

Additional Contributors

Ted Rosenkrantz, MD Professor, Departments of Pediatrics and Obstetrics/Gynecology, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine

Ted Rosenkrantz, MD is a member of the following medical societies: American Academy of Pediatrics, American Pediatric Society, Eastern Society for Pediatric Research, American Medical Association, Connecticut State Medical Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

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