Risk factors for iron deficiency in very preterm infants at 4-6 months corrected age

Landry, Carmen, Dorling, Jon, Kulkarni, Ketan, Campbell-Yeo, Marsha, Vincer, Michael, Ledwidge, Joyce, Morrison, Lisa and Ghotra, Satvinder (2020) Risk factors for iron deficiency in very preterm infants at 4-6 months corrected age. Blood. (doi:10.1182/BLOOD-2020-142442).

Abstract

Iron is an essential micronutrient, especially in infants and young children and is required for erythropoiesis and development of the central nervous system. However, iron deficiency (ID) is the most common micronutrient deficiency worldwide. ID and iron deficiency anemia (IDA) have been associated with poor neurodevelopmental and behavioural outcomes later in life. Preterm infants are particularly at risk of developing ID in early life due to lower iron stores at birth, accelerated growth in the first weeks of life and multiple phlebotomies while in hospital. Therefore, international recommendations suggest prophylactic iron therapy of 2-4 mg/kg/day starting at 2-6 weeks of age until at least 6-12 months in preterm and low birth weight infants. This prophylactic iron supplementation has been shown to be effective at reducing the incidence of ID and IDA. However, the published work mainly involves moderate to late preterm infants and the research is lacking on iron status after discharge in very preterm infants (VPI, <31 weeks gestational age). Based on our previous work, 32% of the VPIs were iron deficient at 4-6 months corrected age despite this early supplementation. Since the development of ID may have permanent detrimental effects on the developing brain of these high-risk preterm infants, a knowledge of risk factors for ID is also important to identify strategies focused on its prevention.

Objective: To investigate the risk factors associated with development of ID

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Contributors

Author: Jon Dorling

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