Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does erythropoietin prevent neurodevelopmental symptoms in neonates with hypoxic ischemic encephalopathy?”

STUDY DESIGN: A systematic review of one randomized, double blind, placebo controlled clinical trial, one randomized, non-blinded, placebo controlled clinical trial, and one case controlled non-randomized, non-blinded prospective pilot trial between 2009-2019, all written in English language and peer reviewed.

DATA SOURCES: The randomized, double blind, placebo controlled clinical trial was found using PubMed. The randomized, non-blinded, placebo controlled clinical trial and casecontrolled pilot study were found on Embase.

OUTCOME MEASURED: The outcome measured was the neurodevelopmental skills. The neurodevelopment of gross motor skills was measured at 9 months of age utilizing the Gesell developmental scale, neurodevelopment of mobility at 12 months of age using a WIDEA scale parental questionnaire, and the Denver Developmental Screening Test II evaluating gross motor skills, fine motor skills, language and personal social skills.

RESULTS: The study conducted by Wu et al.2 evaluated mobility and showed a mean of 28.6 with a SD of 3.8 for the erythropoietin treated group and a mean of 23.8 with a SD of 8.9 for the placebo group, with a P value of .048 showing a significant difference in the erythropoietin treated group. Additionally, the pilot trial conducted by Elmahdy et al.8 had a significant treatment effect in the erythropoietin treated group with a NNT of -2, a large treatment effect at preventing an abnormal Denver Developmental score. However, the study conducted by Lv et al.5 showed a P value of > 0.05 showing an insignificant treatment effect.

CONCLUSIONS: The studies used in this review suggests that erythropoietin may be useful as an adjunctive treatment in preventing poor neurodevelopmental outcomes in neonates with hypoxic ischemic encephalopathy. However, the data is inconsistent between the three studies as two of them showed clinical significance and one did not. Due to the limitations of the studies such as small sample size and lack of long-term evidence of clinical significance with erythropoietin, further research is warranted.