Determinants of Neonatal Iron Stores and Comparison of Appropriate for Gestational Age (Aga) and Small for Gestational Age (Sga) Iron Stores

Abstract

BACKGROUND Sufficient iron stores is of paramount importance in neonatal period. Controversy exists whether transfer of iron to foetus from the mother is determined by foetal requirements or by maternal iron status. Studies correlating maternal and neonatal iron stores revealed conflicting results. The aim of the study is to assess the relationship between maternal and neonatal iron indices at birth and to study the impact of Small for Gestational Age (SGA) status on iron status on cord blood samples and at follow up at 4 weeks. This is a prospective study conducted in tertiary care hospital. Neonates are divided into groups based on Small for Gestational Age (SGA) or Appropriate for Gestational Age (AGA) status. METHODS AND MATERIALS The maternal venous samples were collected 1 hr. ± 15 min prior to the delivery. Cord blood sample and venous samples at 6 weeks were collected from the newborn. Samples were estimated for Haemoglobin (Hb), serum ferritin, serum iron and Total Iron-Binding Capacity (TIBC). RESULTS Total of 172 mother and newborn pairs are enrolled in the study. Significant correlation was found between maternal Hb and neonatal ferritin (Pearson's correlation coefficient = 0.26, p=0.002). Positive significant correlation was found between maternal iron and neonatal iron (Pearson's correlation coefficient = 0.294, p=0.000). Follow up ferritin levels were significantly low in SGA group (Mean ± SD: 173.9 ± 145.8 in SGA vs. 244.3 ± 159.7 in AGA, p=0.040). There was trend towards significance of ferritin levels at birth among AGA and SGA babies (Mean ± SD: 130 ± 85 in SGA vs. 150 ± 77 in AGA, p=0.08). CONCLUSION Neonatal iron stores are affected in case of severe maternal iron deficiency indicated by ferritin levels less than <12 μg/L. Low levels of iron stores at 4 weeks in SGA neonates.