Iron Therapy for Preterm Infants

Rao, Raghavendra; Georgieff, Michael

doi:10.1016/j.clp.2008.09.013

Cited by 136 publications

(142 citation statements)

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“…These visits may have greater importance for premature infants who are at increased risk for medical and neurodevelopmental sequelae. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] There are few studies assessing adherence with health supervision visits in the general pediatric population and fewer in high-risk populations. According to Medical Expenditure Survey data, infants were found to be 83% adherent with the age-specific number of visits recommended by the AAP.…”

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confidence: 99%

Preterm Infant Attendance at Health Supervision Visits

et al. 2015

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OBJECTIVES: To assess the adherence of premature infants with the American Academy of Pediatrics health supervision visit schedule, factors affecting adherence, and the association of adherence with preventive care. METHODS:Retrospective cohort of all infants #35 weeks' gestation, born 2005 to 2009, receiving care at a 30-site primary care network for at least 24 months (n = 1854). Adherence was defined as having a health supervision visit within each expected time period during the first 18 months of life. Logistic regression identified sociodemographic and medical factors associated with nonadherence and risk-adjusted association between nonadherence and outcomes.RESULTS: Only 43% received all expected health supervision visits. Those with Medicaid insurance (adjusted odds ratio [AOR] 0.46, 95% confidence interval [CI] 0.35-0.60), a visit without insurance (AOR 0.46, 95% CI 0.32-0.67), chronic illness (AOR 0.7, 95% CI 0.51-0.97), and black race (AOR 0.7, 95% CI 0.50-0.98) were less adherent, whereas provider continuity of care (AOR 2.89, 95% CI 1.92-4.37) and lower birth weight (AOR 1.67, 95% CI 1.02-2.73) increased adherence. Infants ,100% adherent were less likely to be up to date with immunizations and receive recommended preventive care. In nearly half of missed visit windows, no health supervision visit was scheduled.CONCLUSIONS: Fewer than half of premature infants were fully adherent with the preventive health schedule with associated gaps in health monitoring and immunization delays. These data suggest the importance of health supervision visits and the need to explore scheduling facilitators for those at risk for nonadherence. WHAT'S KNOWN ON THIS SUBJECT:Premature infants are at risk for medical and neurodevelopmental sequelae. Close monitoring is an important role for primary care providers. Premature infants have high use of health care services; however, little is known about the role of health supervision visits. WHAT THIS STUDY ADDS:This study explores the utilization and value of health supervision visits for premature infants. Fewer than half were found to be fully adherent to the health supervision visit schedule, resulting in preventive care gaps and immunization delays.

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confidence: 99%

Preterm Infant Attendance at Health Supervision Visits

et al. 2015

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“…One subject with normal iron store and microcytic hypochromic morphology was advised to undergo hemoglobin analysis to rule out thalassemia. 23 Serum iron and TIBC profiles in our subjects were consistent with IDA pathogenesis, i.e., low SI and high TIBC. Serum iron level is affected by diurnal variation (higher in the afternoon), and iron content in diet.…”

Section: Discussionmentioning

confidence: 61%

“…27 Thus, it is recommended to screen infants at the time of hospital discharge or at the age of 2 months. 23 The recommendation of the American Association of Family Physicians (AAFp) for iron deficiency is to screen preterm infants who do not consume iron-fortified formula at 6 months of age, and to screen low birth weight infants at 9 months of age. 28 Iron and hematology profiles were high at 2 months of CA in our study.…”

Section: Discussionmentioning

confidence: 99%

“…A population study conducted in the US suggested using a combination of two iron markers, Tfsat and the zinc protoporphyrin-ferritin ratio, to diagnose iron deficiency, as these markers can be used to detect iron supply disregulation in erythropoesis before anemia occurs. 23 Serum ferritin is an acute phase protein, which increases during infection or inflammation. 13 In our study, infection was diagnosed by clinical manifestations and simple laboratory examinations; patients with infection were excluded.…”

Section: Discussionmentioning

confidence: 99%

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Iron profiles of preterm infants at two months of chronological age

Puspitasari¹,

Windiastuti²,

Hendarto³

2017

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Background preterm infants are vulnerable to iron deficiency (ID) due to lack of maternal iron stores, repeated phlebotomy, and the body's increased demand for iron during growth. The risk of ID increases at 2 months of age, when hemoglobin (Hb) levels start to decrease. Objective To describe iron profiles in preterm infants at 2 months of chronological age (CA). Methods This cross-sectional study was conducted in 2-month-old infants, born at 32-36 weeks of gestational age, and who visited the Growth and Development Clinics at Cipto Mangunkusumo, Fatmawati, or Budi Kemuliaan Hospitals. parental interviews and medical record reviews were done during the clinic visits. Complete blood count, blood smear, serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (Tfsat), and ferritin level tests were performed. Results Eighty-three subjects were enrolled in this study. The prevalence of iron deficiency anemia (IDA) was 6% and that of ID was 10%. The lowest Hb level found in IDA infants was 6.8 g/dL, the lowest ferritin level was 8.6 ng/mL. Median values for the other tests were: SI 48 µg/dL, TIBC 329µg/dL, and Tfsat 17%. Subjects with IDA were all male (5/5), mostly achieved more than twice their birth weight (4/5), were non-iron supplemented (3/5), born to mothers with low educational background (3/5), and of low socioeconomic status (3/5). Conclusion The prevalence of IDA is 6% and that of ID is 10%. Most subjects with ID and IDA have low SI, high TIBC, low Tfsat, and low ferritin level. Most of the all-male IDA subjects weigh more than twice their birth weight, are non-iron supplemented, and born to mothers with low educational background and low socioeconomic status.

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“…Net 25-85 proc. jau pirmąjį gyvenimo pusmetį nustatoma GS [29]. Taigi neišnešiotų kūdikių GSM profilaktikai buvo skiriamas didelis dėme-sys ir pateiktos aiškios rekomendacijos: nuo 2-6 gyvenimo savaitės iki 6-12 mėn.…”

Section: Geležies Stokos Profilaktikaunclassified

Prophylaxis of Iron Deficiency Anemia in Infants and Todllers: A Multidisciplinary Approach (Literature Review)

Mulevičienė

Ragelienė

2014

Medicinos Teorija Ir Praktika

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Iron deficiency is one of the most common micronutrient deficiency in infancy and childhood. The main long lasting effect of iron deficiency anemia in infancy is poor neurocognitive development. Despite early treatment with iron supplements, lower cognitive performance remains even after reaching adulthood. Therefore iron deficiency anemia should be regarded not only as a haematological problem, but as a result of imperfections in the social system. Preventive strategies occupie most important place ensuring the normal development of the child. The main recommendations regarding iron deficiency prophylaxis are as follows: delayed umbilical cord clamping, exclusive breastfeeding until 6 months of age, iron fortified formula for non-breastfed infants, iron supplements for infants with risk factors, complementary feeding starting at 6 months of age, avoiding cow‘s milk until 12 months of age and restriction of intake to less than 500 ml per day for toddlers. The article analyzes iron deficiency impact on the development of central nervous system, the characteristics of iron homeostasis in children, iron deficiency anemia causes and pathophysiological mechanisms. Based on the latest scientific literature iron deficiency prevention strategies and practical recommendations are provided.

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Iron Therapy for Preterm Infants

Cited by 136 publications

References 83 publications

Preterm Infant Attendance at Health Supervision Visits

Preterm Infant Attendance at Health Supervision Visits

Iron profiles of preterm infants at two months of chronological age

Prophylaxis of Iron Deficiency Anemia in Infants and Todllers: A Multidisciplinary Approach (Literature Review)

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