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Hisano T, Okada J, Tsuda K, Iwata S, Saitoh S, Iwata O. Control variables of serum ferritin concentrations in hospitalized newborn infants: an observational study. Sci Rep 2023; 13:8424. [PMID: 37225866 DOI: 10.1038/s41598-023-35404-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 05/17/2023] [Indexed: 05/26/2023] Open
Abstract
Both iron excess and deficiency are deleterious to cellular and organ homeostasis. Serum ferritin levels serve as a biomarker of iron storage; however, their distribution and determinants in sick newborn infants remain unclear. This study aimed to investigate the reference range and independent variables of serum ferritin in hospitalized newborn infants. All newborn infants who were hospitalized at a tertiary neonatal center within 24 h of birth were retrospectively reviewed for the period of April 2015 through March 2017. Serum ferritin levels were assessed using venous blood samples obtained at admission and their independent variables were explored. The study population comprised 368 infants (36.2 ± 2.8 weeks gestation and 2319 ± 623 g at birth), whose median serum ferritin level was 149 µg/L (inter-quartile range: 81-236). The multivariable model used to explain serum ferritin values comprised hemoglobin, lactate dehydrogenase, blood pH, and maternal hypertensive disorders in pregnancy (all p < 0.01, adjusted for sex and birth weight). Serum ferritin values in hospitalized newborn infants were comparable to those previously reported using umbilical cord blood. Our novel findings indicated the association between blood pH, lactate dehydrogenase, and ferritin levels, suggesting the influence of antenatal hypoxia-ischemia and stress to serum ferritin levels.
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Affiliation(s)
- Tadashi Hisano
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
| | - Junichiro Okada
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan.
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Yoneda N, Yoneda S, Tsuda S, Ito M, Shiozaki A, Niimi H, Yoshida T, Nakashima A, Saito S. Pre-eclampsia Complicated With Maternal Renal Dysfunction Is Associated With Poor Neurological Development at 3 Years Old in Children Born Before 34 Weeks of Gestation. Front Pediatr 2021; 9:624323. [PMID: 33996679 PMCID: PMC8116540 DOI: 10.3389/fped.2021.624323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The purpose of this study was to investigate perinatal factors associated with a poor neurodevelopmental outcome in preterm infants. Methods: A retrospective study was conducted by searching our clinical database between January 2006 and December 2016. A total of 165 singleton children who were born between 23 and 33 weeks of gestation were included. We defined poor neurological development outcomes as follows: cerebral palsy; intellectual disability; developmental disorder including autism and attention-deficit/hyperactivity disorder; low score (<85 points) on Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III); or low score of Kyoto Scale of Psychological Development corrected at 3 years old. We diagnosed maternal renal dysfunction according to the Clinical Practice Guideline for chronic kidney disease 2018 and the Best Practice Guide 2015 for Care and Treatment of Hypertension in Pregnancy. Results: The rate of poor neurological development was 25/165 (15.2%): cerebral palsy (n = 1), intellectual disability (n = 1), developmental disorder (n = 2), low score of Bayley-III (n = 20), and low score of Kyoto Scale of Psychological Development (n = 1). Preeclampsia complicated with maternal renal dysfunction (P = 0.045) and delivery at <30 weeks of gestation (P = 0.007) were independent risk factors for poor neurological development. Conclusions: In addition to previous risk factors such as delivery at <30 weeks of gestation, preeclampsia complicated with renal dysfunction was also associated with poor neurodevelopmental outcomes corrected at 3 years old.
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Affiliation(s)
- Noriko Yoneda
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Satoshi Yoneda
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Sayaka Tsuda
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Mika Ito
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Arihiro Shiozaki
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Hideki Niimi
- Clinical Laboratory Center, Toyama University Hospital, Toyama, Japan
| | - Taketoshi Yoshida
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Akitoshi Nakashima
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
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Martínez-Jiménez MD, Gómez-García FJ, Gil-Campos M, Pérez-Navero JL. Comorbidities in childhood associated with extrauterine growth restriction in preterm infants: a scoping review. Eur J Pediatr 2020; 179:1255-1265. [PMID: 32096070 DOI: 10.1007/s00431-020-03613-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 11/30/2022]
Abstract
Extrauterine growth restriction (EUGR) is a frequent morbidity of preterm infants that can affect short- and long-term prognosis as it involves different EUGR-related alterations in growth and neurological development, as well as cardiometabolic risk. However, knowledge about the prognosis of EUGR is scarce. Thus, the objective of this study is to review the evidence regarding EUGR-related comorbidities in childhood by a systematic approach. This review was carried out using the Joanna Briggs Institute Reviewers' Manual Methodology and the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses)-Search Extension for scoping review. The MEDLINE and EMBASE databases were used to identify papers published until September 2017. Twenty-four publications were included and 19 examined cohort studies. EUGR is mainly associated with (1) lower weight, length, and head circumference measures in childhood; (2) poor neurodevelopment; and (3) alterations in cardiometabolic risk markers. The definition for EUGR and the populations studied differ among authors.Conclusion: EUGR is mainly associated with poor growth and neurodevelopment, as well as with cardiometabolic alterations in childhood. Evidence is based on observational studies with variability in the included populations due to the lack of consensus regarding the definition for EUGR. Finding a gold standard definition becomes paramount in order to select phenotypes at risk later in life. What is known? • EUGR is a frequent condition of preterm infants. Up to date little is known about the effect of the metabolic programming on prognosis. What is new? • The available evidence, which is based on observational studies with variability in the population and the existing different definitions for EUGR, do not enable appropriate data collection. EUGR is mainly associated with poor growth and neurodevelopment, as well as with cardiometabolic alterations in childhood.
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Affiliation(s)
- M D Martínez-Jiménez
- Neonatology Unit. Reina Sofia University Hospital; Pediatric Research Unit, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - F J Gómez-García
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - M Gil-Campos
- Pediatric Research Unit, Reina Sofia University Hospital Maimónides Biomedical Research Institute of Córdoba (IMIBIC), CIBERObn, University of Córdoba, Avda. Menéndez Pidal sn, 14004, Córdoba, Spain.
| | - J L Pérez-Navero
- Department of Pediatrics, Reina Sofia University Hospital; Pediatric Research Unit, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), CIBERER, University of Córdoba, Córdoba, Spain
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Igweze ZN, Ekhator OC, Nwaogazie I, Frazzoli C, Orisakwe OE. Appropriateness of Essentials Trace Metals in Commonly Consumed Infant Formulae in Nigeria. Open Access Maced J Med Sci 2019; 7:4168-4175. [PMID: 32165971 PMCID: PMC7061406 DOI: 10.3889/oamjms.2019.706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mothers who feed their children with infant food have increased have over the years leaving a large percentage of children who consume other types of liquid food for supplementation or as alternatives. AIM Determining the levels of essential trace metals in these formulae with the aim of ascertain their appropriateness is considered important. METHODS Iron, zinc, manganese, chromium and cobalt in 26 infant formulae purchased from Port Harcourt city, Nigeria were determined by Atomic Absorption Spectrophotometry. The estimated daily intake EDI and percentage of EDI to the recommended daily allowance of these essential trace metals were used in the exposure assessment. RESULTS The highest mean concentration of Mn, Cr and Co was found in the milk based (0.15 ± 0.09 mg/kg), (0.61 ± 0.70 mg/kg), (0.12 ± 0.32 mg/kg) compared to the cereal based and cereal mix based but the differences was also not significant. The EDI of chromium in the infant formulae exceeded the RDA. CONCLUSION Infant formulae may add to the chromium body burden of infants in Nigeria.
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Affiliation(s)
- Zelinjo Nkeiruka Igweze
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Madonna University Elele, Rivers State, Nigeria
| | - Osazuwa Clinton Ekhator
- Department of Science Laboratory Technology, Faculty of Life Sciences, University of Benin, Benin, Nigeria
| | - Ify Nwaogazie
- Department of Civil & Environmental Engineering, Faculty of Engineering, University of Port Harcourt, PMB, 5323 Port Harcourt, Rivers State, Nigeria
| | - Chiara Frazzoli
- Department for Cardiovascular, Dysmetabolic and Aging Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Orish Ebere Orisakwe
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port-Harcourt, Rivers State, Nigeria
- World Bank Africa Centre of Excellence in Oilfield Chemicals Research, University of Port Harcourt, PMB, 5323 Port Harcourt, Rivers State, Nigeria
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Volpe JJ. Dysmaturation of Premature Brain: Importance, Cellular Mechanisms, and Potential Interventions. Pediatr Neurol 2019; 95:42-66. [PMID: 30975474 DOI: 10.1016/j.pediatrneurol.2019.02.016] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 02/07/2023]
Abstract
Prematurity, especially preterm birth (less than 32 weeks' gestation), is common and associated with high rates of both survival and neurodevelopmental disability, especially apparent in cognitive spheres. The neuropathological substrate of this disability is now recognized to be related to a variety of dysmaturational disturbances of the brain. These disturbances follow initial brain injury, particularly cerebral white matter injury, and involve many of the extraordinary array of developmental events active in cerebral white and gray matter structures during the premature period. This review delineates these developmental events and the dysmaturational disturbances that occur in premature infants. The cellular mechanisms involved in the genesis of the dysmaturation are emphasized, with particular focus on the preoligodendrocyte. A central role for the diffusely distributed activated microglia and reactive astrocytes in the dysmaturation is now apparent. As these dysmaturational cellular mechanisms appear to occur over a relatively long time window, interventions to prevent or ameliorate the dysmaturation, that is, neurorestorative interventions, seem possible. Such interventions include pharmacologic agents, especially erythropoietin, and particular attention has also been paid to such nutritional factors as quality and source of milk, breastfeeding, polyunsaturated fatty acids, iron, and zinc. Recent studies also suggest a potent role for interventions directed at various experiential factors in the neonatal period and infancy, i.e., provision of optimal auditory and visual exposures, minimization of pain and stress, and a variety of other means of environmental behavioral enrichment, in enhancing brain development.
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Affiliation(s)
- Joseph J Volpe
- Department of Neurology, Harvard Medical School, Boston, Massachusetts; Department of Pediatric Newborn Medicine, Harvard Medical School, Boston, Massachusetts.
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Iron Deficiency and Iron Homeostasis in Low Birth Weight Preterm Infants: A Systematic Review. Nutrients 2019; 11:nu11051090. [PMID: 31100900 PMCID: PMC6566715 DOI: 10.3390/nu11051090] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 02/08/2023] Open
Abstract
Iron is an essential micronutrient that is involved in many functions in humans, as it plays a critical role in the growth and development of the central nervous system, among others. Premature and low birth weight infants have higher iron requirements due to increased postnatal growth compared to that of term infants and are, therefore, susceptible to a higher risk of developing iron deficiency or iron deficiency anemia. Notwithstanding, excess iron could affect organ development during the postnatal period, particularly in premature infants that have an immature and undeveloped antioxidant system. It is important, therefore, to perform a review and analyze the effects of iron status on the growth of premature infants. This is a transversal descriptive study of retrieved reports in the scientific literature by a systematic technique. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were adapted for the review strategy. The inclusion criteria for the studies were made using the PICO (population, intervention, comparison, outcome) model. Consequently, the systematic reviews that included studies published between 2008–2018 were evaluated based on the impact of iron status on parameters of growth and development in preterm infants.
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Moloney L, Rozga M, Fenton TR. Nutrition Assessment, Exposures, and Interventions for Very-Low-Birth-Weight Preterm Infants: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2019; 119:323-339. [DOI: 10.1016/j.jand.2018.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/26/2018] [Indexed: 01/01/2023]
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Volpe JJ. Iron and zinc: Nutrients with potential for neurorestoration in premature infants with cerebral white matter injury. J Neonatal Perinatal Med 2019; 12:365-368. [PMID: 31744026 PMCID: PMC7029313 DOI: 10.3233/npm-190369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Joseph J. Volpe
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Department of Pediatric Newborn Medicine, Harvard Medical School, Boston, MA, USA
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Brigham EP, McCormack MC, Takemoto CM, Matsui EC. Iron status is associated with asthma and lung function in US women. PLoS One 2015; 10:e0117545. [PMID: 25689633 PMCID: PMC4331366 DOI: 10.1371/journal.pone.0117545] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 12/28/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Asthma and iron deficiency are common conditions. Whether iron status affects the risk of asthma is unclear. OBJECTIVE To determine the relationship between iron status and asthma, lung function, and pulmonary inflammation. METHODS Relationships between measures of iron status (serum ferritin, serum soluble transferrin receptor (sTfR), and sTfR/log10ferritin (sTfR-F Index)) and asthma, lung function, and pulmonary inflammation were examined in women 20-49 years in the National Health and Nutrition Examination Survey. Logistic, linear, and quadratic regression models accounting for the survey design of NHANES were used to evaluate associations between iron status and asthma-related outcomes and were adjusted for race/ethnicity, age, smoking status, income, and BMI. RESULTS Approximately 16% reported a lifetime history of asthma, 9% reported current asthma, and 5% reported a recent asthma episode/attack (n = 2906). Increased ferritin (iron stores) was associated with decreased odds of lifetime asthma, current asthma, and asthma attacks/episodes in the range of ferritin linearly correlated with iron stores (20-300ng/ml). The highest quintile of ferritin (>76 ng/ml) was also associated with a decreased odds of asthma. Ferritin levels were not associated with FEV1. Increased values of the sTfR-F Index and sTfR, indicating lower body iron and higher tissue iron need, respectively, were associated with decreased FEV1, but neither was associated with asthma. None of the iron indices were associated with FeNO. CONCLUSION In US women, higher iron stores were inversely associated with asthma and lower body iron and higher tissue iron need were associated with lower lung function. Together, these findings suggest that iron status may play a role in asthma and lung function in US women.
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Affiliation(s)
- Emily P. Brigham
- Johns Hopkins University School of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland, United States of America
| | - Meredith C. McCormack
- Johns Hopkins University School of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland, United States of America
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Clifford M. Takemoto
- Johns Hopkins University School of Medicine, Division of Pediatric Hematology, Baltimore, Maryland, United States of America
| | - Elizabeth C. Matsui
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Johns Hopkins University School of Medicine, Division of Pediatric Allergy and Immunology, Baltimore, Maryland, United States of America
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Géophagie et grossesse : état des connaissances et conduite à tenir. Expérience d’une maternité de Guyane française. ACTA ACUST UNITED AC 2014; 43:496-503. [DOI: 10.1016/j.jgyn.2013.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 05/26/2013] [Accepted: 06/03/2013] [Indexed: 11/18/2022]
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Tsuzuki S, Morimoto N, Hosokawa S, Matsushita T. Associations of maternal and neonatal serum trace element concentrations with neonatal birth weight. PLoS One 2013; 8:e75627. [PMID: 24086594 PMCID: PMC3785479 DOI: 10.1371/journal.pone.0075627] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/19/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Trace elements play important nutritional roles in neonates. Our objective was to examine whether there are differences in maternal/neonatal serum trace element concentrations between mature infants and premature infants. METHODS During 2012, 44 infants born at National Center for Global Health and Medicine, Tokyo, Japan, were enrolled. Serum samples were collected to measure serum iron, zinc, copper, and selenium concentrations 5 days after birth. Maternal serum samples were obtained before delivery and cord blood was taken at delivery to measure the same trace elements. We compared the results between term group whose birth weight were ≥2500 g and gestational age were ≥37 weeks and premature group whose birth weight were <2500 g or gestational age were <37 weeks. Variables significantly different between two groups were included in linear regression models to identify significant predictors of birth weight. Values of P<0.05 were considered statistically significant. RESULTS Serum selenium concentrations were lower in premature group than in term group (43.3±7.0 µg/L vs. 52.0±8.9 µg/L, P = 0.001). Maternal serum selenium concentrations were also significantly lower in the mothers of premature group than in the mothers of term group (79.3±19.3 µg/L vs. 94.1±18.1 µg/L, P = 0.032). There were no significant differences in neonatal or maternal iron, zinc, or copper concentrations between two groups. Multivariate linear regression analysis showed that, except for gestational age, only maternal serum selenium was significantly associated with birth weight (P = 0.015). CONCLUSIONS Serum selenium concentrations were lower in premature group and their mothers compared with the term group. The maternal serum selenium concentration was positively correlated with birth weight. These results suggest that maternal serum selenium concentration may influence neonatal birth weight.
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Affiliation(s)
- Shinya Tsuzuki
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nao Morimoto
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Hosokawa
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeji Matsushita
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
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Long H, Yi JM, Hu PL, Li ZB, Qiu WY, Wang F, Zhu S. Benefits of iron supplementation for low birth weight infants: a systematic review. BMC Pediatr 2012; 12:99. [PMID: 22794149 PMCID: PMC3444344 DOI: 10.1186/1471-2431-12-99] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 07/02/2012] [Indexed: 01/23/2023] Open
Abstract
Background A number of studies have reported on the effects of iron supplementation in low birth weight infants; however, no systematic review of the available evidence has been conducted to date. Hence, we performed a systematic review of the literature to examine the effects of iron supplementation on hematologic iron status, growth, neurodevelopment, and adverse effects in low birth weight/premature infants. Methods We searched the Cochrane Library, Medline, and PubMed for articles reporting on the effects of iron supplementation in low weight infants. The following search terms were used: “preterm born infant(s)/children”; “preterm infants”; “prematurely born children” “weight less than 1500 g at birth”; “born prematurely”; “low birth weight infant(s)”; “infants born preterm”; “prematurity”; “small-for-gestational age”; “very small gestational age infants”; “iron supplementation”; “iron intake”; “iron supplements”; “ferric and/or ferrous compounds”; and “ferrous sulphate/fumarate/sulfate”. Results A total of 15 studies were identified and included in the systematic review. Supplemental iron was given orally or as an iron-fortified formula in 14/15 studies. The duration of treatment ranged from 1 week to 18 months. Iron supplementation significantly increased hematologic measures of iron status (including hemoglobin, hematocrit, serum ferritin) relative to placebo or over time in most studies. All controlled studies that examined iron-deficiency anemia (IDA)/ID reported a decreased prevalence of IDA/ID with iron supplementation. Dose dependent decreases in the prevalence of IDA/ID were reported in several studies. Of the 5 studies reporting on growth, none found any significant effect on growth-related parameters (length, height, weight, and head circumference). Only 2 studies reported on neurodevelopment; no marked effects were reported. There were no consistently reported adverse effects, including oxidative stress, inhibited nutrient absorption, morbidity, or the requirement for blood transfusion. Conclusion The available data suggest that iron supplementation increases the levels of hematologic indicators of iron status and reduces the prevalence of IDA/ID in low birth weight/premature infants. There is insufficient evidence to make a definitive statement regarding the effects of iron supplementation on growth, neurodevelopment, or the occurrence of adverse effects in low birth weight/premature infants.
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Affiliation(s)
- Hui Long
- Department of Pediatrics, General Hospital of Chinese People's Liberation Army, #28 Fuxing Road, Haidian District, Beijing 100853, China
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Amin SB, Scholer L, Srivastava M. Pre-discharge iron status and its determinants in premature infants. J Matern Fetal Neonatal Med 2012; 25:2265-9. [PMID: 22734563 DOI: 10.3109/14767058.2012.685788] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate pre-discharge iron status and identify its determinants in infants' ≤ 32 weeks gestational age (GA). METHODS In a prospective observational study, 24-32 weeks GA infants who did not meet exclusion criteria: congenital viral infections, chromosomal disorders, or cranio-facial anomalies were eligible. Iron status was evaluated by measuring serum ferritin (SF) at 35 weeks post-menstrual age (PMA). Infants with infection or elevated C-reactive protein within 10 days prior to evaluation of iron status were excluded. RESULTS Of 131 infants studied, 23% had latent iron deficiency (SF < 76 ng/ml), 58% had normal iron status (75-400 ng/ml), and 19% had iron overload (SF > 400 ng/ml). On bivariate analysis, preeclampsia, GA, birth weight, patent ductus arteriosus, prior erythrocyte transfusion, phlebotomy loss, and chronic lung disease were associated with iron status. On ordered logistic regression, prior erythrocyte transfusion (frequency [OR 1.41, 95% CI:1.2-1.6] or cumulative amount [OR 1.03, 95% CI:1.02-1.04]) or net erythrocyte balance (amount of erythrocyte transfusion minus phlebotomy loss; OR 1.04, 95% CI:1.02-1.05) was significantly associated with iron status. Among infants who received > three erythrocyte transfusions, 50% developed iron overload. CONCLUSIONS Iron status at 35 weeks PMA is extremely variable and is predicted by prior erythrocyte transfusions or net erythrocyte balance in premature infants.
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Affiliation(s)
- Sanjiv B Amin
- Department of Pediatrics, Division of Neonatology, The University of Rochester School of Medicine and Dentistry , Rochester, NY 14642, USA.
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14
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Wiwanitkit V. Iron and neurodevelopment in infant. Brain Dev 2011; 33:448. [PMID: 20739129 DOI: 10.1016/j.braindev.2010.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Revised: 08/03/2010] [Accepted: 08/03/2010] [Indexed: 11/25/2022]
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Ljung K, Palm B, Grandér M, Vahter M. High concentrations of essential and toxic elements in infant formula and infant foods - A matter of concern. Food Chem 2011; 127:943-51. [PMID: 25214082 DOI: 10.1016/j.foodchem.2011.01.062] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/26/2010] [Accepted: 01/19/2011] [Indexed: 01/27/2023]
Abstract
This study assessed concentrations in and intake of toxic and essential elements from formulas and foods intended for infants during their first 6months of life. Concentrations of the essential elements Ca, Fe, Zn, Mn and Mo were significantly higher in most formulas than in breast milk. Daily intake of Mn from formula varies from ten up to several hundred times the intake of the breast fed infant, levels that may be associated with adverse health effects. One portion of infant food provided significantly more Fe, Mn, Mo, As, Cd, Pb and U than one feeding of breast milk, but less Ca, Cu and Se. Rice-based products in particular contained elevated As concentrations. Drinking water used to mix powdered formula may add significantly to the concentrations in the ready-made products. Evaluation of potentially adverse effects of the elevated element concentrations in infant formulas and foods are warranted.
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Affiliation(s)
- Karin Ljung
- Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
| | - Brita Palm
- Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
| | - Margaretha Grandér
- Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
| | - Marie Vahter
- Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
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