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Maternal and pediatric nutrition

Predictive factors of iron depletion in late preterm infants at the postnatal age of 6 weeks

European Journal of Clinical Nutrition volume 70, pages 941–946 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

Late preterm infants (born ⩾32 weeks of gestation) are at risk for developing iron deficiency and iron deficiency anaemia, and this may lead to impaired neurodevelopment. In the Netherlands, there is no guideline for standardised iron supplementation in these infants. Individualised iron supplementation has been suggested (that is, treating those infants with the highest risk), but risk factors for deprived iron stores in this specific group of infants are not well documented.

Subjects/Methods:

In this prospective multi-centre study, we analysed the iron status at the postnatal age of 6 weeks of 68 infants born between 32 and 35 weeks of gestation in the Netherlands. Serum ferritin (SF) <70 μg/l in the absence of infection (C-reactive protein <5 mg/l) was defined as iron depletion and whenever in combination with a haemoglobin level <110 mg/dl as iron-depleted anaemia. Medical charts were reviewed to identify risk factors.

Results:

Iron depletion and iron-depleted anaemia were present in 38.2% and 30.9% of the infants, respectively. Infants with a birth weight <1830 g and a SF <155 μg/l in the first week of life had a 26.4 times higher risk to develop iron depletion (95% confidence interval 3.1–227.0, P=0.003). Multivariate regression analyses also showed that iron depletion was associated with a higher number of blood draws.

Conclusions:

Iron depletion is common in late preterm infants at the age of 6 weeks in a setting without standardised iron supplementation. One should consider early individualised iron supplementation for late preterm infants with a low birth weight (<1830 g), and a low SF in the first week of life (<155 μg/l), as they have a high risk to develop iron depletion.

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Acknowledgements

This study was registered at the Dutch Trial Register (NTR) (www.trialregister.nl); NTR number: 2828.

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Authors and Affiliations

  1. Department of Paediatrics, Juliana Children’s Hospital/Haga Teaching Hospital, The Hague, The Netherlands

    M D Akkermans, L Uijterschout, L Rövekamp-Abels & F Brus

  2. Department of Paediatrics, Medical Center Alkmaar, Alkmaar, The Netherlands

    M Abbink & B Boersma

  3. Department of Paediatrics, Medical Center Haaglanden, The Hague, The Netherlands

    P Vos

  4. Department of Paediatrics, VU University Medical Center, Amsterdam, The Netherlands

    J B van Goudoever

  5. Department of Paediatrics, Emma Children’s Hospital–Academic Medical Center, Amsterdam, The Netherlands

    J B van Goudoever

Authors
  1. M D Akkermans
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  2. L Uijterschout
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  3. M Abbink
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  4. P Vos
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  7. J B van Goudoever
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Corresponding author

Correspondence to M D Akkermans.

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Competing interests

JBvG is director of the Dutch Human Milk Bank, member of the Dutch Health Council and received grant support/honoraria for lectures or consultancy from Danone Nutricia Research, Mead Johnson Nutritionals, Nestle Nutrition Institute, Hipp and Pharmaceutical United in the previous 3 years. The remaining authors declare no conflict of interest.

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Akkermans, M., Uijterschout, L., Abbink, M. et al. Predictive factors of iron depletion in late preterm infants at the postnatal age of 6 weeks. Eur J Clin Nutr 70, 941–946 (2016). https://doi.org/10.1038/ejcn.2016.34

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  • DOI: https://doi.org/10.1038/ejcn.2016.34

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