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Trends in reticulocyte hemoglobin equivalent values in critically ill neonates, stratified by gestational age

Kendell German1, Phuong T Vu2, Jill D Irvine3

  • 1Division of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, WA, USA. germank@uw.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|July 28, 2019
PubMed

Insights

The reticulocyte hemoglobin equivalent (Ret-He) can indicate iron status in infants. Ret-He levels improved with enteral iron supplementation, showing neonates can enhance iron sufficiency.

Area of Science:

  • Neonatal Medicine
  • Hematology
  • Pediatric Nutrition

Background:

  • Iron deficiency is common in preterm infants.
  • Monitoring iron status in neonates is crucial for development.
  • Reticulocyte hemoglobin equivalent (Ret-He) is a potential biomarker for iron status.

Purpose of the Study:

  • To evaluate the reticulocyte hemoglobin equivalent (Ret-He) as a marker of iron status in infants.
  • To analyze Ret-He trends in relation to iron supplementation in a neonatal intensive care unit (NICU) population.

Main Methods:

  • Retrospective cohort study of 249 infants admitted to a NICU.
  • Analysis of 730 Ret-He measurements within the first 120 days of life.
  • Correlation of Ret-He values with enteral iron sulfate supplementation.

Main Results:

  • Initial Ret-He measurements were lower in infants born before 28 weeks gestation (28.24 pg) compared to those born at or after 28 weeks (33.34 pg).
  • Ret-He values demonstrated an initial decrease followed by a slow uptrend.
  • Infants received increasing doses of enteral iron sulfate, averaging 3.9, 6.5, and 8.2 mg/kg/day at 30, 60, and 90 days, respectively.

Conclusions:

  • Ret-He values show a slow uptrend with enteral iron supplementation after an initial decline.
  • Neonates demonstrate an ability to improve iron sufficiency with appropriate supplementation.
  • Ret-He is a valuable indicator for monitoring iron status and treatment response in infants.
Abstract

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