Early versus late enteral prophylactic iron supplementation in preterm very low birth weight infants: a randomised...

Area of Science:

• Neonatalogy
• Pediatric Nutrition
• Hematology

Background:

• Iron deficiency is common in preterm very low birth weight (VLBW) infants.
• Optimal timing for iron supplementation in VLBW infants is crucial for development.
• Previous studies have shown varied outcomes regarding iron supplementation protocols.

Purpose of the Study:

• To determine if early iron (EI) supplementation at 2 weeks postnatal age improves serum ferritin levels in preterm VLBW infants compared to late iron (LI) supplementation at 6 weeks.
• To evaluate the impact of EI supplementation on hemoglobin levels and neonatal morbidities.

Main Methods:

• A single-blinded, parallel-group, randomized controlled trial was conducted.
• 104 preterm VLBW infants were randomized to receive either EI (2 mg/kg/day) or LI (2 mg/kg/day) starting at 2 or 6 weeks postnatal age, respectively.
• Serum ferritin, hemoglobin, anthropometric parameters, and neonatal morbidities were assessed at 2, 6, and 12 weeks postnatal age.

Main Results:

• Serum ferritin levels at 12 weeks were significantly higher in the EI group (82±5 ng/mL) compared to the LI group (63±3 ng/mL) (p<0.001).
• Hemoglobin levels (10.1±0.4 vs 9.2±0.4 g/dL) and mean corpuscular hemoglobin concentration were also significantly higher in the EI group at 12 weeks (p<0.001).
• No significant differences were observed in neonatal morbidities, anthropometric parameters, or blood transfusion requirements between the groups.

Conclusions:

• Early iron supplementation (starting at 2 weeks) in preterm VLBW infants leads to improved serum ferritin and hemoglobin levels by 12 weeks.
• EI supplementation is safe and effective in enhancing iron status in this vulnerable population.
• The findings support the initiation of iron supplementation earlier in preterm VLBW infants.