Because they received erythropoietin several days or weeks after the insult, its proposed mode of action is thought to be the facilitation of repair, sustaining neuronal growth, and differentiation after brain injury rather than protection against damage itself.6 Meta-analysis of randomized clinical trials with prophylactic erythropoietin showed improved cognitive development in very preterm infants assessed at a corrected age of 18 to 24 months,7 although this effect was completely abolished if 1 study with a high risk of bias was excluded. Here, EPO is linked to injury.