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Serum ferritin, iron levels and iron binding capacity in asymmetric SGA babies
D Karaduman1, H Ergin, I Kiliç
1Department of Pediatrics, Pamukkale University Faculty of Medicine, Denizli, Turkey.
Insights
Small for gestational age (SGA) babies have lower serum ferritin levels, indicating reduced iron stores. Early iron supplementation and anemia monitoring are crucial for these infants.
Area of Science:
- Neonatal Medicine
- Pediatric Hematology
- Nutritional Science
Background:
- Serum ferritin concentration is a key indicator of iron stores, particularly in premature infants.
- Small for gestational age (SGA) infants represent a unique population with potential nutritional challenges.
- Understanding iron status in SGA neonates is critical for timely intervention and long-term health.
Purpose of the Study:
- To investigate and compare serum ferritin levels and iron status in asymmetric SGA infants versus appropriate for gestational age (AGA) infants.
- To assess hemoglobin, serum iron, iron binding capacity, and ferritin levels in newborns within the first six hours of birth.
- To identify potential factors contributing to altered iron status in SGA neonates.
Main Methods:
- A comparative study involving 21 SGA infants and 19 AGA infants.
- Measurement of hemoglobin, serum iron, total iron binding capacity, and serum ferritin levels shortly after birth.
- Statistical analysis to compare iron status parameters between SGA and AGA groups.
Main Results:
- Hemoglobin levels were significantly higher in SGA infants compared to controls (p = 0.001).
- Serum ferritin levels were significantly lower in the SGA group (58.36 +/- 20.1 ng/ml) compared to the AGA group (90.46 +/- 30.5 ng/ml) (p < 0.001).
- While serum iron was decreased and iron binding capacity increased in SGA infants, these differences were not statistically significant (p > 0.05).
Conclusions:
- Term SGA infants exhibit significantly lower serum ferritin levels, suggesting diminished iron stores at birth.
- Potential causes for decreased ferritin include impaired iron transport due to uteroplacental insufficiency or increased iron utilization from enhanced erythropoiesis.
- Prompt iron supplementation and vigilant anemia follow-up are essential for term SGA infants due to the rapid progression of anemia.
Abstract:
The concentration of serum ferritin reflects the extent of iron stores in premature infants. We aimed to determine serum ferritin levels and iron status in asymmetric small for gestational age (SGA) babies. This study was performed on 21 SGA babies and 19 appropriate for gestational age (AGA) babies. Hemoglobin, iron, iron binding capacity and ferritin levels were investigated in the first six hours after the birth. Hemoglobin levels in the SGA and control groups were 20.9 +/- 1.3 (19.4-23.4 g/dl) and 19.6 +/- 0.8 (18.5-21.5 g/dl), respectively (p = 0.001). Serum ferritin levels in the SGA and AGA groups were 58.36 +/- 20.1 ng/ml and 90.46 +/- 30.5 ng/ml, respectively. Ferritin levels were found lower in the SGA group (p < 0.001). In the SGA group, decreased serum iron and increased iron binding capacity were found but the difference was not significant (p > 0.05). Decreased ferritin levels may result from either impaired iron transport associated with uteroplacental vascular insufficiency or increased iron utilization during enhanced erythropoiesis in conditions characterized by chronic fetal hypoxia. Our results stress the significance of iron supplementation and careful anemia follow-up in term SGA babies. Because anemia progress early, beginning iron therapy as soon as possible is a necessity in SGA babies as in prematures.