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Neurological development and iron supplementation in healthy late-preterm neonates: a randomized double-blind
R Luciano1, D M Romeo2, G Mancini3
1Neonatology Unit, Department of Woman and Child Health and Public Health, Child Health Area, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, Rome, Italy. ritapaolamaria.luciano@policlinicogemelli.it.
Insights
Iron supplementation in late-preterm infants (LPT) significantly improved neurodevelopmental outcomes by 12 months. This study recommends iron prophylaxis for all LPT neonates to enhance psychomotor development and reduce long-term risks.
Area of Science:
- Neonatology
- Neurodevelopmental Pediatrics
- Nutritional Science
Background:
- Late-preterm infants (LPT) face higher risks of neurodevelopmental issues and iron deficiency.
- Iron deficiency is a known risk factor for adverse neurological outcomes in infants.
- Early neurodevelopmental outcomes in LPT infants require further investigation.
Purpose of the Study:
- To evaluate the impact of iron supplementation on the psychomotor development of healthy late-preterm infants.
- To determine if iron prophylaxis can mitigate neurodevelopmental sequelae in LPT infants.
- To provide evidence-based recommendations for iron supplementation in this vulnerable population.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- Sixty-six healthy LPT infants (34-36 weeks gestational age) were enrolled.
- Infants received either iron pidolate (2 mg/kg/day) or placebo from 3 weeks to 6 months post-conceptional age, with assessments at 12 months using the Griffiths Mental Development Scales (GMDS).
Main Results:
- Infants receiving iron supplementation showed a significantly higher mean developmental quotient (DQ) at 12 months (121.45 ± 10.53) compared to the placebo group (113.25 ± 9.70) (p < 0.01).
- Significant differences favoring the iron group were observed in GMDS subscales A (p < 0.05), B (p < 0.02), and D (p < 0.01).
- Fifty-two infants completed the 12-month assessment.
Conclusions:
- Iron supplementation during the first six months of life positively impacts the 1-year neurodevelopmental quotient in healthy late-preterm infants.
- The findings support the implementation of iron prophylaxis for all late-preterm neonates.
- Early iron supplementation may be a crucial intervention for improving long-term neurodevelopmental outcomes in LPT infants.
Abstract:
Late-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and iron deficiency. The aim of the study is to assess the positive effect of iron supplementation on psychomotor development in healthy LPT. We designed a randomized placebo-controlled double-blind trial dividing the newborns into two groups. Every patient was assessed using the Griffiths Mental Development Scales (GMDS)-II edition at 12-month post-conceptional age. The study was performed at the Neonatology Unit of our Hospital, in Italy. Sixty-six healthy LPT infants born between 340⁄7 and 366⁄7 weeks of gestational age were enrolled in the study. One group received martial prophylaxis from the third week of life to 6 months of post-conceptional age (2 mg/kg/day of iron pidolate), the other received placebo. Fifty-two of the enrolled infants were assessed using the GMDS at 12-month of post-conceptional age. Statistical analysis of the mean scores of the Griffiths subscales was performed. There was a difference in the mean developmental quotient (DQ) (p < 0.01) between the two groups: iron group mean DQ 121.45 ± 10.53 vs placebo group mean DQ 113.25 ± 9.70. Moreover, mean scores of the Griffiths subscales A, B, and D showed significant differences between the two groups (scale A p < 0.05, scale B p < 0.02, scale D p < 0.01, respectively).Conclusions: We recommend that all LPT neonates receive iron supplementation during the first 6 months of life in order to improve their 1-year neurodevelopmental quotient. What is Known: • Late-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and also for iron deficiency. • Iron deficiency is an independent risk factor for adverse neurological outcomes. What is New: • Healthy late-preterm who received iron supplementation during the first 6 months of life achieved better neurological outcomes at 12-month post-conceptional age than LPT who received placebo. • Our study strongly supports the need for the implementation of martial prophylaxis in LPT neonates.
