Korean J Perinatol.  2013 Dec;24(4):275-280. 10.14734/kjp.2013.24.4.275.

Comparison of Iron Status between Fullterm and Preterm Infants : An Experience in a Single Hospital for 2 Years

• Lee SI
• Kim HM
• Kim WH

• KMID: 2072304
• DOI: http://doi.org/10.14734/kjp.2013.24.4.275

Abstract

PURPOSE
The aim of this study is to compare the iron status of fullterm and preterm infants and to investigate effects of gender, IUGR, and maternal diabetes mellitus (DM) on iron status of infants.
METHODS
We evaluated newborn infants admitted at neonatal intensive care unit (NICU) of Kyungpook National University Hospital from July 2011 to April 2013. The five parameters were measured: hemoglobin, hematocrit, ferritin, total iron binding capacity, and transferrin saturation.
RESULTS
Serum ferritin was lower in preterm infants than in fullterm infants (209.5 vs 323.5 ng/mL, P=0.003). Hemoglobin, hematocrit, total iron binding capacity, and transferrin saturation levels were not influenced by gestational age. Maternal DM was associated with decreased serum ferritin (204.3 vs 347.8 microg/L, P=0.008). There was no difference of ferritin levels between male and female as well as between IUGR infants and non-IUGR infants.
CONCLUSION
In this study, low gestational ages and maternal DM are associated with low ferritin level. Careful monitoring of iron status is required for preterm infants and infants of DM mother.

Keyword

Ferritin; Fullterm; Preterm infants

MeSH Terms

Diabetes Mellitus
Female
Ferritins
Fetal Growth Retardation
Gestational Age
Gyeongsangbuk-do
Hematocrit
Humans
Infant
Infant, Newborn
Infant, Premature*
Intensive Care, Neonatal
Iron*
Male
Mothers
Transferrin
Ferritins
Iron
Transferrin

Reference

1). de Deungria M., Rao R., Wobken JD., Luciana M., Nelson CA., Georgieff MK. Perinatal iron deficiency decreases cytochrome c oxidase (CytOx) activity in selective regions of neonatal rat brain. Pediatr Res. 2000. 48:169–76.

2). Siimes MA., Addiego JE Jr., Dallman PR. Ferritin in serum: diagnosis of iron deficiency and iron overload in infants and children. Blood. 1974. 43:581–90.

3). Cook JD. Clinical evaluation of iron deficiency. Semin He-matol. 1982. 19:6–18.

4). MacPhail AP., Charlton RW., Bothwell TH., Torrance JD. The relationship between maternal and infant iron status. Scand J Hematol. 1980. 25:141–50.

5). Cook JD., Skikne BS. Iron deficiency: definition and diagnosis. J Intern Med. 1989. 226:349–55.

6). Siddappa AM., Rao R., Long JD., Widness JA., Georgieff MK. The assessment of newborn iron stores at birth: a review of the literature and standards for ferritin concentrations. Neonatology. 2007. 92:73–82.

7). Sweet DG., Savage GA., Tubman R., Lappin TR., Halliday HL. Cord blood transferrin receptors to assess fetal iron status. Arch Dis Child Fetal Neonatal Ed. 2001. 85:F46–8.

8). Lozoff B., Jimenez E., Wolff AW. Long-term developmental outcome of infants with iron deficiency. N Engl J Med. 1991. 325:687–94.

9). Dallman PR. Iron. Brown ML, editor. Present knowledge in nutrition. 6th ed, Washington: International Life Sciences Institute-Nutritional Foundation;1990. p. 241–3.

10). Sweet DG., Savage G., Tubman R., Lappin TR., Halliday HL. Study of maternal influences on fetal iron status at term using cord blood transferrin receptors. Arch Dis Child Fetal Neonatal Ed. 2001. 84:F40–3.

11). Tamura T., Hou J., Goldenberg RL., Johnston KE., Cliver SP. Gender difference in cord serum ferritin concentrations. Biol Neonate. 1999. 75:343–9.

12). Simmons D., France JT., Keelan JA., Song L., Knox BS. Sex differences in umbilical cord serum levels of inhibin, testosterone, estradiol, dehydroepiandrosterone sulphate, and sex hormone-binding globulin in human term neonates. Biol Neonate. 1994. 65:287–94.

13). Georgieff MK., Landon MB., Mills MM., Hedlund BE., Faassen AE., Schmidt RL, et al. Abnormal iron distribution in infants of diabetic mothers: spectrum and maternal antecedents. J Pediatr. 1990. 117:455–61.

14). Milley JR., Papacostas JS., Tabata BK. Effect of insulin on uptake of metabolic substrates by the sheep fetus. Am J Physiol. 1986. 251:E349–56.

15). Briana DD., Boutsikou T., Baka S., Boutsikou M., Stamati L., Hassiakos D, et al. Perinatal role of hepcidin and iron homeostasis in full-term intrauterine growth-restricted infants. Eur J Haematol. 2013. 90:37–44.

16). Chockalingam UM., Murphy E., Ophoven JC., Weisdorf SA., Georgieff MK. Cord transferrin and ferritin values in newborn infants at risk for prenatal uteroplacental insufficiency and chronic hypoxia. J Pediatr. 1987. 111:283–6.

17). Emamghorashi F., Heidari T. Iron status of babies born to iron-deficient anaemic mothers in Iranian hospital. East Mediterr Health J. 2004. 10:808–14.