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Iron status at 9 months of infants with low iron stores at birth
Michael K Georgieff1, Sandi W Wewerka, Charles A Nelson
1Departments of Pediatrics, the Institute for Child Development, and the Center for Neurobehavioral Development, University of Minnesota, Minneapolis, USA.
Insights
Infants born with low iron stores (serum ferritin) maintain lower levels at 9 months. This early iron deficiency may increase the risk for later iron problems.
Area of Science:
- Neonatal Nutrition
- Pediatric Iron Metabolism
Background:
- Low serum ferritin at birth may indicate compromised iron stores in newborns.
- Early life iron status is crucial for infant development and long-term health.
Purpose of the Study:
- To assess the 9-month iron status of infants born with low cord serum ferritin.
- To compare iron status, deficiency incidence, and growth in infants with low vs. normal birth ferritin.
Main Methods:
- Longitudinal study comparing infants with low (<5th percentile) vs. normal (>80 microg/L) cord serum ferritin.
- Serum ferritin levels measured at birth and 9 months; iron deficiency and anemia assessed.
- Infant growth rates (0-12 months) and feeding practices recorded.
Main Results:
- Infants with low birth ferritin had significantly lower serum ferritin at 9 months (30 vs. 57 microg/L).
- No iron deficiency or anemia observed in either group at 9 months.
- Faster growth correlated with lower follow-up ferritin only in the low birth ferritin group.
Conclusions:
- Infants born with low serum ferritin concentrations exhibit persistently lower levels at 9 months.
- These infants may face an elevated risk of developing iron deficiency later in the first two years of life.
Objective:
To determine the 9-month follow-up iron status of infants born with abnormally low serum ferritin concentrations.
Study Design:
Ten infants of >34 weeks' gestation with cord serum ferritin concentrations <5th percentile at birth (<70 microg/L) and 12 control infants with cord serum ferritin concentrations >80 microg/L had follow-up serum ferritin concentrations measured at 9 +/- 1 month of age. The mean follow-up ferritins, incidences of iron deficiency and iron-deficiency anemia, and growth rates from 0 to 12 months were compared between the two groups.
Results:
At follow-up, the low birth ferritin group had a lower mean ferritin than the control group (30 +/- 17 vs 57 +/- 33 microg/L; P =.03), but no infant in either group had iron deficiency (serum ferritin <10 microg/L) or iron-deficiency anemia. Both groups grew equally well, but more rapid growth rates were associated with lower follow-up ferritin concentrations only in the low birth ferritin group (r = -0.52; P =.05). Both groups were predominantly breast-fed without iron supplementation before 6 months.
Conclusions:
Infants born with serum ferritin concentrations <5th percentile continue to have significantly lower ferritin concentrations at 9 months of age compared with infants born with normal iron status, potentially conferring a greater risk of later onset iron deficiency in the second postnatal year.