Effects of Iron Supplementation on Auditory Brainstem Response in Marginally LBW Infants

Berglund, Staffan; Westrup, Björn; Haraldsson, Erik; Engström, Birgitta; Domellöf, Magnus

doi:10.1203/pdr.0b013e3182320cd0

Cited by 17 publications

(30 citation statements)

References 57 publications

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“…Iron plays an important role in the development of the central nervous system and is essential to neural myelination and neurotransmitter function. Iron deficiency anemia during infancy is associated with poor neurological development [105,106]. However, it is important to state that there are some concerns regarding iron supplementation because humans have no system for iron excretion; since preterm infants are particularly vulnerable to oxygen radical injury, iron supplementation can be harmful for the preterm brain [105,106].…”

Section: Dietary Intervention Studies For Brain and Cognitive Devementioning

confidence: 99%

“…In contrast, no improvement in hearing nerve responses (Central Conduction Time) [105] or in cognitive performance assessed with the WPPSI (Wechsler Preschool and Primary Scale of Intelligence) at pre-school age [107] could be demonstrated with these iron doses. An intervention with higher doses, e.g., >3 mg iron/kg/day, does not appear to add any beneficial effects on motor and neurological development compared to 2 mg/kg/day [108].…”

Section: Dietary Intervention Studies For Brain and Cognitive Devementioning

confidence: 99%

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Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature

Schneider

García-Ródenas

2017

Nutrients

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Adequate nutrition is important for neurodevelopmental outcomes in preterm-born infants. In this review, we aim to summarize the current knowledge on nutritional interventions initiated during the hospital stay targeting brain and cognitive development benefits in preterm human infants. Studies can broadly be split in general dietary intervention studies and studies investigating specific nutrients or nutritional supplements. In general, mother’s breast milk was reported to be better for preterm infants’ neurodevelopment compared to infant formula. The differences in methodologies make it difficult to conclude any effects of interventions with individual nutrients. Only protein and iron level studies showed some consistent findings regarding optimal doses; however, confirmatory studies are needed. This review does not support some widely accepted associations, such as that between long-chain polyunsaturated fatty acid supplementation and visual development. Clear nutritional recommendations cannot be made based on this review. However, the type of infant nutrition (i.e., breast milk versus formula or donor milk), the timing of the nutritional intervention, and the dose of the nutrient/supplement have been found to be relevant factors in determining the success of nutritional intervention studies in preterm infants.

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Section: Dietary Intervention Studies For Brain and Cognitive Devementioning

confidence: 99%

Section: Dietary Intervention Studies For Brain and Cognitive Devementioning

confidence: 99%

Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature

Schneider

García-Ródenas

2017

Nutrients

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“…However, a recent study by Bergland et al challenges these links [20]. The study is the largest to date relating iron to ABR in infants.…”

Section: Discussionmentioning

confidence: 99%

“…The considerable variability in study findings means that the issue of sex differences in auditory brainstem development remains unresolved. Research on other factors that might affect ABR development, such as the rate of physical growth and iron status/supplementation, is limited and, again, results are conflicting [18–20]. …”

Section: Introductionmentioning

confidence: 99%

Sex and gestational age effects on auditory brainstem responses in preterm and term infants

Zhu

Mai

et al. 2013

Early Human Development

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Background Some studies find delayed development of the auditory brainstem in preterm infants, but others do not. Aim To compare auditory brainstem responses (ABRs) in healthy preterm and term infants depending on sex and gestational age (GA). Methods Participants were 111 preterm (27–36 weeks GA) and 92 term (37–41 weeks GA) infants. ABR tests were conducted at 6 weeks (corrected age if preterm). Results There were no overall differences between term and preterm groups in ABRs. However, males showed longer latencies for waves III, V, and I–III, III–V, and I–V intervals and smaller amplitudes for wave III and V than females in both preterm and term groups (all p values ≤ .01). A 3-way interaction between group, sex, and GA (p < .05) showed that preterm males with later GA had longer wave I–V interval, whereas term females with later GA showed shorter wave I–V interval. Growth velocity predicted wave I–V interval in preterm infants, controlling for other factors (male: p = .07, female: p < .05). Conclusion ABRs in preterm and term infants were similar at 6 weeks (corrected age if preterm), but males had less advanced ABRs than females. More rapid growth predicted less mature ABR in later GA preterm infants in this setting where they were unlikely to receive extra iron. The roles of GA, growth, and iron balance in ABR development warrant further study.

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“…ABR waveforms were analyzed for latencies for component peaks I, III, and V. We focused on wave V latency and central conduction time (CCT), which is the interpeak latency from wave I to wave V. These measures have been suggested as useful measures of auditory processing because they are easily identifiable and reproducible. [46] Wave V is frequently used as an indicator of the neurological integrity of the auditory system. [47]…”

Section: Methodsmentioning

confidence: 99%

Prenatal exposure to multiple pesticides is associated with auditory brainstem response at 9months in a cohort study of Chinese infants

Sturza

Silver

et al. 2016

Environment International

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Background Pesticides are associated with poorer neurodevelopmental outcomes, but little is known about the effects on sensory functioning. Methods Auditory brainstem response (ABR) and pesticide data were available for 27 healthy, full-term 9-month-old infants participating in a larger study of early iron deficiency and neurodevelopment. Cord blood was analyzed by gas chromatography-mass spectrometry for levels of 20 common pesticides. The ABR forward-masking condition consisted of a click stimulus (masker) delivered via ear canal transducers followed by an identical stimulus delayed by 8, 16, or 64 milliseconds (ms). ABR peak latencies were evaluated as a function of masker-stimulus time interval. Shorter wave latencies reflect faster neural conduction, more mature auditory pathways, and greater degree of myelination. Linear regression models were used to evaluate associations between total number of pesticides detected and ABR outcomes. We considered an additive or synergistic effect of poor iron status by stratifying our analysis by newborn ferritin (based on median split). Results Infants in the sample were highly exposed to pesticides; a mean of 4.1 pesticides were detected (range 0-9). ABR Wave V latency and central conduction time (CCT) were associated with the number of pesticides detected in cord blood for the 64ms and non-masker conditions. A similar pattern seen for CCT from the 8ms and 16ms conditions, although statistical significance was not reached. Increased pesticide exposure was associated with longer latency. The relation between number of pesticides detected in cord blood and CCT depended on the infant’s cord blood ferritin level. Specifically, the relation was present in the lower cord blood ferritin group but not the higher cord blood ferritin group. Conclusions ABR processing was slower in infants with greater prenatal pesticide exposure, indicating impaired neuromaturation. Infants with lower cord blood ferritin appeared to be more sensitive to the effects of prenatal pesticide exposure on ABR latency delay, suggesting an additive or multiplicative effect.

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Effects of Iron Supplementation on Auditory Brainstem Response in Marginally LBW Infants

Cited by 17 publications

References 57 publications

Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature

Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature

Sex and gestational age effects on auditory brainstem responses in preterm and term infants

Prenatal exposure to multiple pesticides is associated with auditory brainstem response at 9months in a cohort study of Chinese infants

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