Iron Sulfate Supplementation Decreases Zinc Protoporphyrin to Heme Ratio in Premature Infants

Miller, Susan M.; McPherson, Ronald J.; Juul, Sandra E.

doi:10.1016/j.jpeds.2005.08.052

Cited by 41 publications

(37 citation statements)

References 26 publications

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“…It must be however noted that the sample size in their study was much smaller than the sample size of our study. Similarly, Miller et al 24, in their study on iron supplementation at a dose of 3–12 mg/kg/day in 7- to 60-day-old preterm babies of 24–32 weeks gestation, could not find any changes in conventional measures of iron status. The differences in the results of the aforementioned studies could also be related to heterogeneity of study populations, with inclusion of different gestational ages, birth weights and timing of iron initiation.…”

Section: Discussionmentioning

confidence: 87%

Early versus late enteral prophylactic iron supplementation in preterm very low birth weight infants: a randomised controlled trial

Joy

Krishnamurthy

Adhisivam

et al. 2013

Arch Dis Child Fetal Neonatal Ed

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Section: Discussionmentioning

confidence: 87%

Early versus late enteral prophylactic iron supplementation in preterm very low birth weight infants: a randomised controlled trial

Joy

Krishnamurthy

Adhisivam

et al. 2013

Arch Dis Child Fetal Neonatal Ed

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“…Fortunately, enteral iron has not been shown to increase markers of oxidative injury [15,16,17]. Nevertheless, side effects of oral iron supplementation such as lower rate of weight gain [18] and impaired growth in length [19] have been described in older, iron-replete children.…”

Section: Introductionmentioning

confidence: 99%

A Review of Cord Blood Concentrations of Iron Status Parameters to Define Reference Ranges for Preterm Infants

Lorenz¹,

Peter

Poets³

et al. 2013

Neonatology

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Background: Iron plays an essential role in various tissue functions, and hence the reliable assessment of iron nutrition status of preterm infants appears to be mandatory. Objectives: To summarize available data on cord blood concentrations of iron status parameters as surrogate reference ranges for preterm infants until term-equivalent age. Methods: Review of the literature searching PubMed for cord blood values of hemoglobin, mean corpuscular volume, ferritin, soluble transferrin receptor, ferritin index, transferrin saturation, reticulocyte hemoglobin content, zinc protoporphyrin/heme ratio, and hepcidin and comparison with reference ranges established for adults. Results: Gestational age-specific cord blood concentration ranges at term were computed as weighted mean for hemoglobin [15.9 g/dl (13.3-18.4)], mean corpuscular volume [108.1 fl (97.8-118.5)] and transferrin saturation [61.2% (31.5-90.9)] and listed for ferritin, soluble transferrin receptor, ferritin index, zinc protoporphyrin/heme ratio, reticulocyte hemoglobin content and hepcidin. These surrogate reference ranges were markedly different from adult values. Conclusion: Reference ranges of iron status parameters established for adults are probably not suitable to define iron status in preterm infants. If iron supplementation in preterm infants should be individually adjusted based on iron status parameters, it may be necessary to aim for cord blood concentration ranges to enable optimal growth and development.

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“…borns and those without transfusions [5,6] . At NICU discharge, ZnPP/H was lower in transfused vs. untransfused infants [7] .…”

mentioning

confidence: 99%

Zinc Protoporphyrin/Heme in Large-for-Gestation Newborns

Kleven¹,

Blohowiak²,

Kling³

2007

Neonatology

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Background: Zinc protoporphyrin/heme (ZnPP/H) ratios are indicators of incomplete erythrocyte iron delivery. ZnPP/H is more sensitive than measures of iron stores, such as plasma ferritin, in identifying early pre-anemic iron-deficient erythropoiesis. Cord ZnPP/H ratios are elevated in conditions associated with fetal hypoxia, such as diabetes mellitus during pregnancy. In chronic fetal hypoxemia, erythrocyte and hemoglobin syntheses are accelerated and iron is incorporated into erythrocytes. Cord ZnPP/H ratios are correlated with fetal size after diabetic pregnancy. Because fetal size is a surrogate for diabetes control, it is unclear whether glycemic control in diabetes mellitus or fetal size was the major determinant of ZnPP/H ratios and disturbed erythrocyte iron delivery. Objective: Our goal was to examine whether ZnPP/H ratios were elevated or were associated with growth in large-for-gestation newborns born to mothers without the diagnosis of diabetes mellitus. Methods: In cord blood samples from large and appropriately grown healthy newborns, we measured ZnPP/H and indices of erythropoiesis and iron status. Analyses included simple linear regression, Fisher’s exact, and unpaired t testing. Results: In the absence of diabetes mellitus, ZnPP/H in 25 large and 24 appropriately grown healthy newborns was similar, and the ratios were within the limits of previously reported normal cord ZnPP/H. Ratios were not correlated with plasma ferritin levels. In large newborns, but not appropriately grown newborns, ZnPP/H ratios were positively correlated with fetal growth (p < 0.03) and estimates of body hemoglobin (p <0.04). Conclusions: Despite 33% greater body hemoglobin mass observed in healthy large, compared to appropriately grown newborns, mean ZnPP/H was normal. Iron incorporation into erythrocytes in large newborns appears adequate. Because the association of ZnPP/H with size and estimated body hemoglobin was observed only in large newborns, factors determining ZnPP/H may differ between large and appropriately grown newborns.

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Iron Sulfate Supplementation Decreases Zinc Protoporphyrin to Heme Ratio in Premature Infants

Cited by 41 publications

References 26 publications

Early versus late enteral prophylactic iron supplementation in preterm very low birth weight infants: a randomised controlled trial

Early versus late enteral prophylactic iron supplementation in preterm very low birth weight infants: a randomised controlled trial

A Review of Cord Blood Concentrations of Iron Status Parameters to Define Reference Ranges for Preterm Infants

Zinc Protoporphyrin/Heme in Large-for-Gestation Newborns

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