Iron in fetal and neonatal nutrition

Rao, Raghavendra; Georgieff, Michael

doi:10.1016/j.siny.2006.10.007

Cited by 223 publications

(208 citation statements)

References 70 publications

(11 reference statements)

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Methodsmentioning

confidence: 99%

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

2011

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Objective: The study's objective was to compare hematocrit (Hct) levels at 36 to 48 h of age in term infants delivered by cesarean section exposed to immediate cord clamping or umbilical cord milking (UCM).Study Design: In this randomized controlled trial, 24 women scheduled for elective cesarean section were randomized to either immediate clamping (<10 s) or UCM (milked Â 5 by the obstetrical provider) at birth.Result: All subjects received their allocated intervention. The milking group had a smaller placental residual blood volume (13.2 ± 5.6 vs 19.2±5.4 ml kg -1 , P ¼ 0.01) and higher Hct levels at 36 to 48 h (57.5 ± 6.6 vs 50.0 ± 6.4 %, P ¼ 0.01). Five infants (42%) in the immediate group had a Hct of p47%, indicative of anemia.Conclusion: UCM results in placental transfusion in term infants at the time of elective cesarean section with higher Hct levels at 36 to 48 h of age.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

2011

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2007

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Objectives: Hemolysis is a significant complication of extracorporeal membrane oxygenation (ECMO), with a reported incidence of 12.2%. The aims of this study were (1) to investigate hemolysis caused by saline-washed versus unwashed RBCs, (2) to determine in vitro the effects of saline washing on erythrocyte hemolytic markers and (3) to investigate hemolysis by centrifugal versus roller pumps.Study design: (1) To evaluate the effect of pre-transfusion saline-washing versus non-washing, the peak plasma-free hemoglobin (FHb) and total bilirubin in the first 3 days versus the next 4 days of ECMO were compared (2) Pre-and postsaline-washed RBCs were analyzed for K þ , hemoglobin, mean corpuscular volume, FHb and hemolysis at baseline and after 4 h of storage at 41C. (3) Over 10 000 neonatal ECMO cases were retrospectively reviewed to study the effect of pump type on hemolysis.Results: (1) The washed blood group had significantly more hemolysis within the first 3 days of ECMO. (2) Immediately after saline washing, the K þ and Hb concentrations were significantly decreased compared with unwashed blood, and these differences were maintained after 4 h. The osmotic fragility of washed RBCs after 4 h of storage at 41C was significantly higher than at baseline. (3) Hemolysis was reported more often in the centrifugal than in the roller pump group.Conclusions: (1) Using unwashed RBCs decreased hemolysis within the first 3 days of ECMO. (2) Saline washing, while decreasing the concentration of K þ in the plasma, significantly increases RBC membrane osmotic fragility. (3) Hemolysis is linked to the use of centrifugal pumps.

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“…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.…”

Section: Sample Characteristicsmentioning

confidence: 99%