Related Experiment Video
Updated: Aug 20, 2026
Quantitating Iron Transport Across the Mouse Placenta In Vivo Using Nonradioactive Iron Isotopes
Published on: May 10, 2022
Oral iron supplementation in preterm infants treated with erythropoietin
Toru Fujiu1, Kenichi Maruyama, Takenobu Koizumi
1Department of Neonatology, Gunma Children's Medical Center, Gunma, Japan. tfujiu@gcmc.pref.gunma.jp
Insights
Moderate oral iron supplementation did not improve red blood cell production in very low-birthweight infants receiving erythropoietin. Iron levels were lower in controls, but treatment success rates were similar between groups.
Area of Science:
- Neonatal Medicine
- Pediatric Hematology
- Clinical Nutrition
Background:
- Erythropoiesis in very low-birthweight (VLBW) infants is complex.
- The role of moderate oral iron supplementation alongside recombinant human erythropoietin (EPO) is not fully understood.
Purpose of the Study:
- To investigate if moderate oral iron supplementation enhances erythropoiesis in VLBW infants treated with EPO.
- To assess the impact on hemoglobin levels, reticulocyte counts, and transfusion needs.
Main Methods:
- A randomized controlled trial involving 24 VLBW infants (750-1499 g).
- Infants received 8 weeks of subcutaneous EPO (400 IU/kg/week).
- One group received daily oral iron (4 mg/kg/day), while the control group did not.
Main Results:
- Hemoglobin and absolute reticulocyte counts were similar in both groups throughout the study.
- Serum ferritin levels were significantly lower in the control group at study exit and follow-up.
- Treatment success rates (defined by hemoglobin levels and transfusion avoidance) did not differ between groups.
Conclusions:
- Moderate oral iron supplementation did not show a clear benefit for erythropoiesis in EPO-treated VLBW infants.
- Further research is needed to determine if higher iron doses could enhance erythropoiesis in this population.
Background:
It is not known whether a moderate dose of oral iron supplementation would further enhance erythropoiesis in recombinant human erythropoietin (EPO)-treated very low-birthweight (VLBW) infants.
Methods:
In total, 24 preterm infants with birthweights 750-1499 g were enrolled at the age of 14-28 days to receive 400 IU/kg per week EPO subcutaneously for 8 weeks. The infants were randomly allocated either to receive oral iron supplementation 4 mg/kg per day or to serve as controls.
Results:
Hemoglobin and the absolute reticulocyte count in the iron supplementation and the control groups remained identical throughout the study period, whereas serum ferritin was significantly lower in the control group at study exit and follow up. Rates of treatment success (no need for transfusion and hemoglobin never below 8 g/dL) also did not differ between the groups.
Conclusions:
In this study we did not find a clear advantage in a moderate dose of oral iron supplementation on erythropoiesis in EPO-treated VLBW infants. Whether a higher dose would lead to enhanced erythropoiesis remains to be answered.
