Related Experiment Video
Updated: Oct 16, 2025
Quantitating Iron Transport Across the Mouse Placenta In Vivo Using Nonradioactive Iron Isotopes
Published on: May 10, 2022
Iron Status of the Moderate and Late Preterm Infant: A Prospective Cohort Study
Alok Kumar M K1, Femitha Pournami1, Jyothi Prabhakar1
1Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, India.
Insights
Moderate to late preterm infants receiving oral iron showed high variability in iron status, with 8.5% still iron deficient at 4 months. Monitoring iron levels is recommended for personalized supplementation in these infants.
Area of Science:
- Neonatal Medicine
- Pediatric Nutrition
- Hematology
Background:
- Micronutrient guidelines for moderate to late preterm infants (MLP) are often extrapolated from studies on smaller preterm infants.
- There is a lack of systematic studies on the physiological iron status of MLP.
- Current iron supplementation practices for MLP vary significantly.
Purpose of the Study:
- To prospectively investigate the iron status of MLP at 4 months corrected age.
- To determine the proportion of MLP who are iron replete (neither deficient nor in excess).
- To analyze iron deficiency anemia, growth, development, and risk factors for iron deficiency in MLP.
Main Methods:
- Prospective study of 82 infants born between 32 and 36 weeks gestation.
- Measurement of serum ferritin (SF) and hematological indices at 4 months corrected age.
- Infants received 2 mg/kg/day oral iron from 6 weeks postnatal age.
Main Results:
- 90.3% of MLP were iron replete at 4 months corrected age.
- High variability in SF levels was observed (median 57.45 μg/l, IQR 37.02-98.85).
- Despite supplementation, 8.5% of MLP remained iron deficient.
Conclusions:
- Significant variability in serum ferritin levels suggests a need for monitoring iron status in MLP.
- Individualized iron supplementation advice may be beneficial for this population.
- Further research is warranted to optimize iron management in moderate to late preterm infants.
Abstract:
Guidelines on micronutrient supplementation in moderate to late preterm infants (MLP) are mostly extrapolated from those for smaller preterms, largely due to lack of systematic studies on physiological status in this special group of infants. Actual practices vary widely. We prospectively studied iron status by measurement of serum ferritin (SF) and haematological indices at 4 months corrected age in infants born between 32 and 36 weeks gestation (MLP), after they received 2 mg/kg/day oral iron from 6 weeks of postnatal age. Proportion of MLP having normal iron status (iron replete), i.e., neither iron deficiency (ID) nor iron excess was measured. ID anaemia, growth and development, risk factors for ID were also analysed. Of the 82 infants studied, 78% babies were late preterm. Seventy-four (90.3%) were iron replete (no deficiency or excess) at 4 months. High variability in SF levels (minimum of 9.8 to maximum of 252.2 μg/l) with median (IQR) of 57.45 μg/l (37.02-98.85) was noted in the entire cohort; and also within those who were iron deficient with median (IQR) of 17.50 μg/l (11.70-18.90). There was no difference in haematological indices of ID infants when compared to those with normal iron status. Inspite of oral iron supplementation with reasonable compliance, 8.5% MLP were iron deficient at 4 months corrected age. The high variability noted in SF levels could justify the need for monitoring iron status in this group of preterm infants. This could quintessentially aid individualization of iron supplementation advice.
