Iron in fetal and neonatal nutrition

Abstract

SummaryBoth iron deficiency and iron excess during the fetal and neonatal period bode poorly for developing organ systems. Maternal conditions such as iron deficiency, diabetes mellitus, hypertension and smoking, and preterm birth are the common causes of perinatal iron deficiency. Long-term neurodevelopmental impairments and predisposition to future iron deficiency that are prevalent in infants with perinatal iron deficiency require early diagnosis, optimal treatment and adequate followup of infants at risk for the condition. However, due to the potential for oxidant-mediated tissue injury, iron overload should be avoided in the perinatal period, especially in preterm infants.

Umbilical cord milking in term infants delivered by cesarean section: a randomized controlled trial

“…17 Five infants from the ICC group (45%) had a capillary Hct level of p47%, suggestive of anemia. 18 Table 2 provides information about jaundice and hyperbilirubinemia. Total serum bilirubin (TSB) levels were ordered by the pediatricians when jaundice was suspected.…”

“…It was collected and analyzed by the laboratory personnel. The following infant data was collected at the time of hospital discharge: admission temperature (axillary, 1F), initial mean blood pressure (B3 h of age measured by Dynamap, GE Healthcare, Milwaukee, WI, USA), feeding type, discharge weight, percentage of weight loss or gain, an assessment of bilirubin levels using the AAP Hour Specific Nomogram for Bilirubin Risk Stratification (http://www.bilitool.org), any evidence of polycythemia (venous Hct >65%), 17 anemia (capillary Hct p47%) 18 and any undesired neonatal conditions. At 10 to 14 days postpartum, a phone interview was conducted and the mother was queried about infant feeding status, any infant evaluation or treatment for jaundice, as well as any emergency room visits and/or hospital readmission since being discharged.…”

Increased hemolysis from saline pre-washing RBCs or centrifugal pumps in neonatal ECMO

“…Hemolyzed RBCs release non-protein bound free iron that is implicated in poor neurodevelopment. 2,3 In addition, high total plasma bilirubin has been associated with kernicterus, although this association is not as clear-cut as the association of plasma-free bilirubin with neurotoxicity. 4 These concerns led us to investigate variables pre-and during ECMO that might affect RBC hemolysis after ECMO, namely the saline pre-washing of the blood used for the ECMO, and the kind of pump used during ECMO.…”

Erythrocyte indices and serum ferritin in newborns

“…4 Low serum ferritin values are good indicators of iron deficiency; high values in contrast, are usually associated with inflammation/infection and frequently associated with IUGR. (24,26) In fact, serum ferritin may not be the appropriate indicator of iron deposit in SGA newborns; however there is no standard test for the diagnosis of iron status at birth (27) and, in this case, a combination of different tests would be appropriate.…”