Related Experiment Video
Updated: May 24, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Association between neonatal iron overload and early human brain development in premature infants
Sanjiv B Amin1, Gary Myers, Hongyue Wang
1Department of Pediatrics, Division of Neonatology, The University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States. Sanjiv_amin@urmc.rochester.edu
Insights
Neonatal iron overload in premature infants did not significantly impact neurodevelopment. This study found no association between elevated iron levels and developmental impairments in early infancy.
Area of Science:
- Neonatal care
- Neurodevelopmental pediatrics
- Iron metabolism
Background:
- Emerging evidence links excess iron to adverse brain development.
- The impact of neonatal iron overload on infant neurodevelopment in premature infants remains unclear.
Purpose of the Study:
- To investigate the association between neonatal iron overload and neurodevelopmental outcomes in premature infants.
Main Methods:
- Prospective cohort study of premature infants (24-32 weeks gestational age).
- Serum ferritin (SF) measured at 34-35 weeks post-menstrual age (PMA).
- Neurodevelopmental assessment at 8-12 months of age.
Main Results:
- 95 premature infants were studied; 25 had iron overload (SF >400 ng/ml).
- A trend towards increased neurodevelopmental impairment in the iron overload group (64% vs. 41%) was observed (p=0.05).
- After adjusting for confounders, iron overload was not significantly associated with neurodevelopmental impairment (Adjusted OR 0.71).
Conclusions:
- Modest neonatal iron overload does not appear to be associated with neurodevelopmental impairment in infancy among premature infants.
Background:
Emerging evidence suggests that excess iron may be detrimental for brain development. However, little is known regarding the association between neonatal iron overload and subsequent neurodevelopment during infancy in vulnerable premature infants.
Aims:
To evaluate the association between neonatal iron overload and neurodevelopment in premature infants.
Study Design:
Prospective cohort study.
Subjects:
24-32 weeks gestational age infants who had serum ferritin (SF) measured at 34-35 weeks post-menstrual age (PMA) and did not meet exclusion criteria: SF<76 ng/ml, toxoplasmosis, syphilis, rubella, cytomegalovirus, herpes infections, chromosomal disorders, or craniofacial anomalies were eligible. In addition, infants with sepsis or elevated C-reactive protein within 10 days before their SF measurement were excluded.
Outcome Measures:
Infants were evaluated for neurodevelopmental outcome at 8-12 months of age and were deemed to have neurodevelopmental impairment if they had one or more of the following: mental developmental index<70, abnormal neurological examination, bilateral blindness, bilateral deafness, or required occupational, physical, or speech therapy.
Results:
95 infants were studied. 70 had normal iron status (SF 76-400 ng/ml) while 25 were deemed to have iron overload (SF >400 ng/ml) at 34-35 weeks PMA. There was a marginal increase in neurodevelopmental impairment among infants with iron overload compared to infants with normal iron status (64% vs. 41%, p=0.05). However, after controlling for confounders, iron overload was not associated with neurodevelopmental impairment (Adjusted OR 0.71, 95% CI, 0.21-2.5).
Conclusion:
Modest neonatal iron overload is not associated with neurodevelopmental impairment during infancy in premature infants.
