Background Certain gestational conditions associated with decreased fetal iron delivery and/or increased fetal iron demand beyond the placental transport capacity can result in perinatal iron deficiency (PID).
Objective To determine the 12-month follow up iron status of infants born with abnormally low serum ferritin concentrations (SF).
Methods 35 infants with cord SF<50μg/L and 35 control infants with cordSF>150μg/L had iron status follow up, during the first year of life. Full blood counts, SF, soluble transferin receptor (sTfR) and erythropoietin levels were measured in neonates and their mothers at delivery and at 12 months.
Results There was no difference between the mean serum hemoglobin (Hb) and SF in mothers and neonates in both groups. Of the neonates with PID the sTfR levels were significantly higher in the premature (42.2±15.5 vs 30.7±15 mg/ml) and the erythropoietin levels were significantly higher in the full term neonates (37±38.8 vs 5.7±1.8). At 12 months, in the low birth ferritin group, the Hb and SF were significantly lower in the premature neonates (11.6±0.9 vs 12.2±0.8, 17.2±10.1 vs 30.6±19) and Hb levels were significantly lower in the full term neonates (11.6±0.2 vs 12.5±0.9). Of the low birth ferritin group, the premature infants were mostly twins while the full terms were infants of diabetic mothers. 50% of the neonates had iron deficiency anemia.
Conclusions Maternal iron deficiency affects fetal iron status but doesn’t represent a significant predisposing factor. PID in full term neonates is mostly associated with gestational conditions that are characterized by augmented erythropoesis while in premature neonates with decreased fetal iron delivery. Some neonates with PID are still iron deficient at 12 months of age, therefore iron supplementation must be individualized.
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