The iron status at birth of neonates with risk factors for developing iron deficiency: a pilot study

MacQueen, Brianna C.; Christensen, Robert D.; Ward, Diane McVey; Bennett, Sterling T.; O’Brien, Elizabeth; Sheffield, Mark J.; Baer, Vickie L.; Snow, Greg; Lewis, K A Weaver; Fleming, Robert E.; Kaplan, Jerry

doi:10.1038/jp.2016.234

Cited by 37 publications

(38 citation statements)

References 36 publications

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“…5 All high-risk neonates (including preterm infants, infants of diabetic mothers, infants born to anemic or iron deficient mothers, and infants of smokers) should be screened at birth for ID [38]. …”

Section: Discussion/conclusionmentioning

confidence: 99%

Perinatal Iron Deficiency: Implications for Mothers and Infants

Juul¹,

Derman²,

Auerbach³

2019

Neonatology

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Iron deficiency, with or without anemia, is common in pregnant women. In fact, nearly 30% of reproductive-age women are anemic worldwide, and anemia in pregnancy has an estimated global prevalence of 38%. Severe anemia can substantially increase the risk of maternal mortality, and can adversely affect fetal development. In this review, we examine the available data regarding epidemiology and consequences of iron deficiency in mothers and infants, current treatment strategies, and make recommendations for screening and treatment of iron deficiency anemia in gravidas and neonates.

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Section: Discussion/conclusionmentioning

confidence: 99%

Perinatal Iron Deficiency: Implications for Mothers and Infants

Juul¹,

Derman²,

Auerbach³

2019

Neonatology

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“…"DIC" was coded when there was abnormal clinical bleeding, oozing, or bruising, along with a fibrinogen level below the 5th percentile lower reference interval for age, and a PT, aPTT, and D-dimers all > 95th percentile upper reference interval for age [11]. Biochemical "iron deficiency" was defined by only one parameter, which was one or more reticulocyte hemoglobin content values < 25 pg [12,13]. "Small for gestational age" was coded when the birth weight was below the 10th percentile for gestational age of our population.…”

Section: Methodsmentioning

confidence: 99%

Automated Quantification of Fragmented Red Blood Cells: Neonatal Reference Intervals and Clinical Disorders of Neonatal Intensive Care Unit Patients with High Values

et al. 2018

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Background: Schistocytes are circulating erythrocyte fragments. They can be identified microscopically from a blood smear; but automated systems evaluate more cells and avoid inconsistencies in microscopy. Studies using adult subjects indicate that automated quantification of schistocytes can be clinically useful. However, reference intervals for automated schistocyte counts of neonates have not been published, and the relevance of a high automated schistocyte count from neonates has not been reported. Objectives: Using retrospective automated neonatal complete blood count (CBC) data, we created reference intervals for fragmented red cells (FRCs) and sought to discover the clinical conditions of neonates with high FRCs (above the upper reference interval). Results: We created reference intervals based on 39,949 CBCs from 15,655 neonates 0–90 days old. The lower reference interval was 0 FRC/µL and the upper interval was 100,000/µL. The highest FRCs (96 CBCs from 44 neonates) were > 250,000/µL. These neonates clustered into the following groups: 37% had sepsis, 29% had disseminated intravascular coagulation (DIC), 17% had a genetic syndrome, 14% necrotizing enterocolitis (NEC), and 7% had iron deficiency (some had more than one diagnosis). Based on the reference intervals, we divided the 39,949 FRC values into 3 groups: (1) < 100,000/µL (“normal”), (2) 100,000–200,000/µL (“moderately elevated”), and (3) > 200,000/µL (“extremely elevated”). The odds that a microangiopathic condition (DIC, sepsis, NEC) or a microcytic disorder (iron deficiency) were present were significantly higher in the moderately elevated, and more so in the extremely elevated group. Conclusions: Our study suggests that a high FRC could prompt investigation into, or inform follow-up of, a neonatal microangiopathic or extremely microcytic disorder.

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“…14 We are currently engaged in a much larger validating study to identify NICU patients with iron deficiency and to assess the pathogenesis. Meanwhile, for iron guideline development, we elected to adopt a modification of the recommendation of the World Review of Nutrition and Dietetics, which advocates starting iron supplementation at 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

Iron Supplements for Infants at Risk for Iron Deficiency

MacQueen

Baer

Scott

et al. 2017

Global Pediatric Health

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Professional societies have published recommendations for iron dosing of preterm neonates, but differences exist between guidelines. To help develop standardized guidelines, we performed a 10-year analysis of iron dosing in groups at risk for iron deficiency: IDM (infants of diabetic mothers), SGA (small for gestational age), and VLBW premature neonates (very low birth weight, <1500 g). We analyzed iron dosing after red cell transfusions and erythropoiesis-stimulating agents (ESA). Of IDM, 11.8% received iron in the hospital; 9.8% of SGA and 27.1% of VLBW neonates received iron. Twenty percent of those who received iron had it started by day 14; 63% by 1 month. Supplemental iron was stopped after red cell transfusions in 73% of neonates receiving iron. An ESA was administered to 1677, of which 33% received iron within 3 days. This marked variation indicates that a consistent approach is needed, and using this report and a literature review, we standardized our iron-dosing guidelines.

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The iron status at birth of neonates with risk factors for developing iron deficiency: a pilot study

Cited by 37 publications

References 36 publications

Perinatal Iron Deficiency: Implications for Mothers and Infants

Perinatal Iron Deficiency: Implications for Mothers and Infants

Automated Quantification of Fragmented Red Blood Cells: Neonatal Reference Intervals and Clinical Disorders of Neonatal Intensive Care Unit Patients with High Values

Iron Supplements for Infants at Risk for Iron Deficiency

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