Pediatric research

Evaluating iron status and the risk of anemia in young infants using erythrocyte parameters.

PMID 23168578


Correct evaluation of iron status is important in young infants because both iron deficiency and excess may have negative effects on development, growth, and morbidity. We evaluated iron status using erythrocyte parameters, including reticulocyte hemoglobin content (CHr) in infants with birth weight <3,000 g (n = 80). Blood samples and infant characteristics were recorded at 6 wk and at 4 and 6 months. Infants with a birth weight ≤2,500 g (n = 36) were recommended for iron supplementation. Despite a significantly poorer status at 6 wk, iron-supplemented infants had significantly higher hemoglobin level (Hb): 12.2 (SD = 0.8) g/dl and CHr: 28.3 (SD = 1.4) pg at 6 mo, as compared with nonsupplemented infants, Hb: 11.7 (SD = 1.0) g/dl, P = 0.02 and CHr: 26.5 (SD = 2.5) pg, P < 0.001. Prolonged exclusive breastfeeding, high weight gain, and male gender were the predisposing factors for a low iron status at 6 mo. A CHr cutoff level of 26.9 pg at 4 mo proved to be a sensitive predictor for anemia at 6 mo. Signs of an iron-restricted erythropoiesis were observed in nonsupplemented infants (birth weight 2,501-3,000 g), and CHr was a useful tool for evaluating iron status. The need for iron supplementation in certain infant risk populations should be further evaluated.

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Iron(II) fumarate, 97%