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A review of cord blood concentrations of iron status parameters to define reference ranges for preterm infants
Laila Lorenz1, Andreas Peter, Christian F Poets
1Department of Neonatology, University Children's Hospital of Tübingen, Tübingen, Germany.
Insights
Assessing iron status in preterm infants is crucial. This study establishes cord blood reference ranges for iron parameters, highlighting differences from adult values to guide infant nutrition.
Area of Science:
- Neonatal nutrition
- Pediatric hematology
- Iron metabolism
Background:
- Iron is vital for infant tissue function.
- Accurate assessment of iron status in preterm infants is essential.
- Existing adult reference ranges may not apply to neonates.
Purpose of the Study:
- To establish surrogate reference ranges for iron status parameters in preterm infants.
- Utilize cord blood concentrations for this purpose.
- Provide data up to term-equivalent age.
Main Methods:
- Literature review of PubMed.
- Collected cord blood data for key iron status markers.
- Compared neonatal values with adult reference ranges.
Main Results:
- Computed gestational age-specific cord blood ranges for hemoglobin, mean corpuscular volume, and transferrin saturation.
- Reported ranges for ferritin, soluble transferrin receptor, and other markers.
- Demonstrated significant differences between preterm infant and adult iron status values.
Conclusions:
- Adult iron status reference ranges are likely unsuitable for preterm infants.
- Cord blood concentration ranges are proposed as optimal targets.
- Individualized iron supplementation may require these neonatal-specific ranges.
Background:
Iron plays an essential role in various tissue functions, and hence the reliable assessment of iron nutrition status of preterm infants appears to be mandatory.
Objectives:
To summarize available data on cord blood concentrations of iron status parameters as surrogate reference ranges for preterm infants until term-equivalent age.
Methods:
Review of the literature searching PubMed for cord blood values of hemoglobin, mean corpuscular volume, ferritin, soluble transferrin receptor, ferritin index, transferrin saturation, reticulocyte hemoglobin content, zinc protoporphyrin/heme ratio, and hepcidin and comparison with reference ranges established for adults.
Results:
Gestational age-specific cord blood concentration ranges at term were computed as weighted mean for hemoglobin [15.9 g/dl (13.3-18.4)], mean corpuscular volume [108.1 fl (97.8-118.5)] and transferrin saturation [61.2% (31.5-90.9)] and listed for ferritin, soluble transferrin receptor, ferritin index, zinc protoporphyrin/heme ratio, reticulocyte hemoglobin content and hepcidin. These surrogate reference ranges were markedly different from adult values.
Conclusion:
Reference ranges of iron status parameters established for adults are probably not suitable to define iron status in preterm infants. If iron supplementation in preterm infants should be individually adjusted based on iron status parameters, it may be necessary to aim for cord blood concentration ranges to enable optimal growth and development.
