Browse > Article
http://dx.doi.org/10.5223/pghn.2015.18.2.100

The Iron Status of Very Low Birth Weight Infants Receiving Multiple Erythrocyte Transfusions during Hospitalization in the Neonatal Intensive Care Unit  

Park, Sook-Hyun (Department of Pediatrics, Kyungpook National University School of Medicine)
Kim, Heng-Mi (Department of Pediatrics, Kyungpook National University School of Medicine)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.18, no.2, 2015 , pp. 100-107 More about this Journal
Abstract
Purpose: We investigated the iron status of very low birth weight infants receiving multiple erythrocyte transfusions during hospitalization in the neonatal intensive care unit (NICU). Methods: We enrolled 46 very low birth weight infants who were admitted to the Kyungpook National University Hospital between January 2012 and December 2013. Serum ferritin was measured on their first day of life and weekly thereafter. We collected individual data of the frequency and volume of erythrocyte transfusion and the amount of iron intake. Results: A total of 38 (82.6%) of very low birth weight infants received a mean volume of $99.3{\pm}93.5mL$ of erythrocyte transfusions in NICU. The minimum and maximum serum ferritin levels during hospitalization were $146.2{\pm}114.9ng/mL$ and $456.7{\pm}361.9ng/mL$, respectively. The total volume of erythrocyte transfusion was not correlated to maximum serum ferritin concentrations after controlling for the amount of iron intake (r=0.012, p=0.945). Non-transfused infants took significantly higher iron intake compared to infants receiving ${\geq}100mL/kg$ erythrocyte transfusion (p<0.001). Minimum and maximum serum ferritin levels of non-transfused infants were higher than those of infants receiving <100 mL/kg erythrocyte transfusions (p=0.026 and p=0.022, respectively). Infants with morbidity including bronchopulmonary dysplasia or retinopathy of prematurity received a significantly higher volume of erythrocyte transfusions compared to infants without morbidity (p<0.001). Conclusion: Very low birth weight infants undergoing multiply erythrocyte transfusions had excessive iron stores and non-transfused infants also might had a risk of iron overload during hospitalization in the NICU.
Keywords
Iron; Very low birth weight infant; Erythrocyte transfusions; Ferritins;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Dallman PR. Biochemical basis for the manifestations of iron deficiency. Annu Rev Nutr 1986;6:13-40.   DOI
2 Singla PN, Gupta VK, Agarwal KN. Storage iron in human foetal organs. Acta Paediatr Scand 1985;74:701-6.   DOI
3 Shaw JC. Iron absorption by the premature infant. The effect of transfusion and iron supplements on the serum ferritin levels. Acta Paediatr Scand Suppl 1982;299:83-9.
4 Widness JA, Seward VJ, Kromer IJ, Burmeister LF, Bell EF, Strauss RG. Changing patterns of red blood cell transfusion in very low birth weight infants. J Pediatr 1996;129:680-7.   DOI
5 Sullivan JL. Iron, plasma antioxidants, and the 'oxygen radical disease of prematurity'. Am J Dis Child 1988;142:1341-4.
6 Rao R, Georgieff MK. Iron therapy for preterm infants. Clin Perinatol 2009;36:27-42.   DOI
7 Cooke RW, Drury JA, Yoxall CW, James C. Blood transfusion and chronic lung disease in preterm infants. Eur J Pediatr 1997;156:47-50.
8 Inder TE, Clemett RS, Austin NC, Graham P, Darlow BA. High iron status in very low birth weight infants is associated with an increased risk of retinopathy of prematurity. J Pediatr 1997;131:541-4.   DOI
9 Dorea JG. Iron and copper in human milk. Nutrition 2000;16:209-20.   DOI
10 Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001;163:1723-9.   DOI
11 Siddappa AM, Rao R, Long JD, Widness JA, Georgieff MK. The assessment of newborn iron stores at birth: a review of the literature and standards for ferritin concentrations. Neonatology 2007;92:73-82.   DOI
12 Messer RD, Russo AM, McWhirter WR, Sprangemeyer D, Halliday JW. Serum ferritin in term and preterm infants. Aust Paediatr J 1980;16:185-8.
13 Mukhopadhyay K, Yadav RK, Kishore SS, Garewal G, Jain V, Narang A. Iron status at birth and at 4 weeks in preterm-SGA infants in comparison with preterm and term-AGA infants. J Matern Fetal Neonatal Med 2012;25:1474-8.   DOI
14 Singla PN, Tyagi M, Shankar R, Dash D, Kumar A. Fetal iron status in maternal anemia. Acta Paediatr 1996;85:1327-30.   DOI
15 Chockalingam UM, Murphy E, Ophoven JC, Weisdorf SA, Georgieff MK. Cord transferrin and ferritin values in newborn infants at risk for prenatal uteroplacental insufficiency and chronic hypoxia. J Pediatr 1987;111:283-6.   DOI
16 Hirano K, Morinobu T, Kim H, Hiroi M, Ban R, Ogawa S, et al. Blood transfusion increases radical promoting non-transferrin bound iron in preterm infants. Arch Dis Child Fetal Neonatal Ed 2001;84:F188-93.   DOI
17 Georgieff MK, Landon MB, Mills MM, Hedlund BE, Faassen AE, Schmidt RL, et al. Abnormal iron distribution in infants of diabetic mothers: spectrum and maternal antecedents. J Pediatr 1990;117:455-61.   DOI
18 Arad I, Konijn AM, Linder N, Goldstein M, Kaufmann NA. Serum ferritin levels in preterm infants after multiple blood transfusions. Am J Perinatol 1988;5:40-3.   DOI
19 Bard H, Widness JA. The life span of erythrocytes transfused to preterm infants. Pediatr Res 1997;42:9-11.   DOI
20 Jacobs A. Ferritin: an interim review. Curr Top Hematol 1985;5:25-62.
21 Zhuang T, Han H, Yang Z. Iron, oxidative stress and gestational diabetes. Nutrients 2014;6:3968-80.   DOI
22 Knutson MD, Walter PB, Ames BN, Viteri FE. Both iron deficiency and daily iron supplements increase lipid peroxidation in rats. J Nutr 2000;130:621-8.   DOI
23 Lachili B, Hininger I, Faure H, Arnaud J, Richard MJ, Favier A, et al. Increased lipid peroxidation in pregnant women after iron and vitamin C supplementation. Biol Trace Elem Res 2001;83:103-10.   DOI
24 Romagnoli C, Zecca E, Gallini F, Girlando P, Zuppa AA. Do recombinant human erythropoietin and iron supplementation increase the risk of retinopathy of prematurity? Eur J Pediatr 2000;159:627-8.   DOI