Eur J Clin Nutr. 2015 May;69(5):598-602. doi: 10.1038/ejcn.2014.217. Epub 2014 Oct 15.

Iron deficiency in the first 6 months of age in infants born between 32 and 37 weeks of gestational age

Uijterschout L1, Domellöf M2, Abbink M3, Berglund SK2, van Veen I1, Vos P4, Rövekamp L1, Boersma B3, Hudig C5, Vos R6, van Goudoever JB7, Brus F1.

Author information

1 – Department of Pediatrics, Juliana Children’s Hospital/HAGA Teaching Hospital, The Hague, The Netherlands.
2 – Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
3 – Department of Pediatrics, Medical Center Alkmaar, Alkmaar, The Netherlands.
4 – Department of Pediatrics, Medical Center Haaglanden, The Hague, The Netherlands.
5 – LabWest, HAGA Teaching Hospital, The Hague, The Netherlands.
6 – Haga Academy, HAGA Teaching Hospital, The Hague, The Netherlands.
7 – [1] Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands [2] Department of Pediatrics, Emma Children’s Hospital – Academic Medical Center, Amsterdam, The Netherlands.

Abstract

BACKGROUND/OBJECTIVES: Preterm infants are at risk of iron deficiency (ID). In the Netherlands, preterm infants born after 32 weeks of gestational age (GA) do not receive iron supplementation on a routine basis. We hypothesized that dietary iron intake in these infants might not be sufficient to meet the high iron requirements during the first 6 months of life.

SUBJECTS/METHODS: In a prospective cohort study, we analyzed the prevalence and risk factors of ID in 143 infants born between 32+0 and 36+6 weeks GA who did not receive iron supplementation.

RESULTS: ID at the age of 4 and 6 months was present in 27 (18.9%) and 7 (4.9%) infants. Results of a multivariable logistic regression analysis showed that ID was associated with lower birth weight, a shorter duration of formula feeding, more weight gain in the first 6 months of life and lower ferritin concentrations at the age of 1 week.

CONCLUSIONS: Preterm infants born after 32 weeks GA have an increased risk of ID compared with those born at term, supporting the need of iron supplementation. Our results suggests that measurement of ferritin at the age of 1 week might be useful to identify those infants at particular risk and could be used in populations without general supplementation programs. However, the efficacy and safety of individualized iron supplementation, based on ferritin concentrations at the age of 1 week, together with other predictors of ID, needs to be further investigated, preferably in a randomized controlled trial.

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