Postdischarge iron status in very preterm infants receiving prophylactic iron supplementation after birth

Landry, Carmen, Dorling, Jon, Kulkarni, Ketan, Campbell-Yeo, Marsha, Morrison, Lisa, Ledwidge, Joyce, Vincer, Michael and Ghotra, Satvinder (2022) Postdischarge iron status in very preterm infants receiving prophylactic iron supplementation after birth. Journal of Pediatrics, 247, 74-80.e2. (doi:10.1016/j.jpeds.2022.04.050).

Abstract

Objective: to determine postdischarge iron status and associated factors in very preterm infants.

Study design: a retrospective cohort study was conducted through a provincial database on all very preterm infants born in Nova Scotia between 2005 and 2018. As a standard of care, all infants received prophylactic iron supplements starting at 2-4 weeks of chronological age and were tested for iron deficiency at 4 or 6 months corrected age. Iron deficiency was defined as serum ferritin <20 g/L at 4 months or <12 g/L at 6 months. Multivariate logistic regression analysis identified factors associated with iron deficiency.

Results: among 411 infants, 132 (32.1%) had iron deficiency and 11 (2.7%) had iron deficiency anemia. The prevalence of iron deficiency decreased over time, from 37.6% in 2005-2011 to 25.8% in 2012-2018. Gestational hypertension in the mother (P = .01) and gestational age <27 weeks (P = .02) were independent risk factors for iron deficiency. In addition, the odds of iron deficiency were lower in the mixed-fed group (ie, with breast milk and formula combined) compared with the exclusive formula-fed group (P = .01).

Conclusions: iron deficiency was prevalent in 32% of the very preterm infants despite early iron prophylaxis. These results demonstrate the importance of monitoring iron stores during preterm follow-up. Information about risk factors is important to mitigate iron deficiency in very preterm infants.

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Contributors

Author: Jon Dorling

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