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  • Original Article
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Iron supplementation for preterm infants receiving restrictive red blood cell transfusions: reassessment of practice safety

Journal of Perinatology volume 30, pages 736–740 (2010)Cite this article

Subjects

Abstract

Objective:

To reassess iron supplementation practice safety in very low birth weight (VLBW) preterm infants receiving restrictive red blood cell transfusions during initial hospitalization.

Study Design:

Iron status, including hemoglobin (Hb), serum iron, ferritin, and soluble transferrin receptor (sTfR) levels and reticulocyte count of transfused (n=236) and non-transfused (n=166) preterm infants at ⩽24 h and 2, 4 and 8 weeks were recorded. As per protocol, a restrictive blood transfusion policy and supplementation of 5 mg kg–1 per day of iron polymaltose complex from 4 weeks and 25 mg–1 per day of vitamin E from 2 weeks were imposed for all infants. Normative reference cord-blood ferritin value of preterm infants was used for comparison. Vitamin E levels and incidence of morbidities associated with prematurity were recorded.

Result:

At ⩽24 h, the characteristics and iron status of both groups were similar. At 2, 4 and 8 weeks, the transfused group had significantly higher Hb, iron and ferritin levels; sTfR levels were lower at 4 and 8 weeks (all indices, P<0.05). At 8 weeks, the median ferritin levels of our transfused group were lower than that of normative reference cord-blood value (115 (50th percentile) vs 79 (43 to 107) μg l–1, respectively). Vitamin E levels and the incidence of morbidities associated with prematurity of the transfused and non-transfused groups were not different (both indices, P>0.18).

Conclusion:

Adding iron supplementation to preterm infants receiving restrictive blood transfusions has shown to be a judicious and safe practice in terms of iron status for VLBW preterm infants.

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Authors and Affiliations

  1. Department of Neonatology, Meir Medical Center, Kfar Saba, Israel

    S Arnon, T Dolfin, S Bauer, R H Regev & I Litmanovitz

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    S Arnon, T Dolfin, R H Regev & I Litmanovitz

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  1. S Arnon
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  2. T Dolfin
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  3. S Bauer
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  4. R H Regev
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  5. I Litmanovitz
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Correspondence to S Arnon.

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Arnon, S., Dolfin, T., Bauer, S. et al. Iron supplementation for preterm infants receiving restrictive red blood cell transfusions: reassessment of practice safety. J Perinatol 30, 736–740 (2010). https://doi.org/10.1038/jp.2010.33

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