Control variables of serum ferritin concentrations in hospitalized newborn infants: an observational study

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.

Hemoglobin, Ferritin, and Lactate Dehydrogenase as Predictive Markers for Neonatal Sepsis

“…However, in the adult population, ferritin levels exceeding 300 ng/mL had a sensitivity of 60% and a specificity of 70% in detecting sepsis [28]. Furthermore, the correlation between ferritin levels and control variables, including birth weight and its z-score, as well as those linked to infection and inflammation, was validated in the neonatal population [29]. Additionally, serum ferritin seems to be a more accurate indicator of neonatal sepsis mortality risk than CRP [30].…”

A Comprehensive Review on Serum Ferritin as a Prognostic Marker in Intensive Care Units: Insights Into Ischemic Heart Disease

“…Regulation at the translation level: The ferritin synthesis is meticulously governed at the translation level of the ferritin gene, with intricate feedback mechanisms orchestrated in response to fluctuations in iron levels [ 14 ]. Within ferritin, the H subunit converts excessive intracellular ferric ions into ferrous iron, whereas the L subunit stores ferrous iron within the cells, reflecting the overall ferritin content in the body [ 14 ].…”

“…Influence of iron status and inflammation: Serum ferritin levels act as indicators of both iron excess and deficiency, with variations mirroring alterations in body iron reserves and inflammatory states [ 9 , 14 ]. Elevated serum ferritin is commonly associated with inflammatory diseases and malignancies, underscoring its significance as a crucial clinical marker [ 9 ].…”

“…Clinical applications: In clinical practice, serum ferritin is significant in evaluating total body iron stores, diagnosing iron deficiency, and managing conditions associated with iron overload [ 9 ]. In neonates, serum ferritin levels are influenced by various factors, including intrauterine growth, maturation, antenatal infections, inflammation, maternal age, and pregnancy-induced hypertension, reflecting its complex interplay with developmental and physiological processes [ 14 ].…”