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Control variables of serum ferritin concentrations in hospitalized newborn infants: an observational study
Tadashi Hisano1,2, Junichiro Okada2, Kennosuke Tsuda1
1Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan.
Insights
Serum ferritin levels in hospitalized newborns were determined, revealing associations with hemoglobin, lactate dehydrogenase, blood pH, and maternal hypertensive disorders. These findings suggest influences from antenatal hypoxia-ischemia and stress on infant iron status.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Hematology
Background:
- Iron homeostasis is critical for cellular and organ function, with both excess and deficiency being harmful.
- Serum ferritin is a key biomarker for iron storage, but its levels and determinants in sick neonates are not well understood.
- Establishing reference ranges for serum ferritin in hospitalized infants is essential for accurate clinical assessment.
Purpose of the Study:
- To determine the reference range of serum ferritin in hospitalized newborn infants.
- To identify independent variables associated with serum ferritin levels in this population.
- To explore the relationship between serum ferritin and factors like antenatal conditions and physiological markers.
Main Methods:
- Retrospective review of 368 hospitalized newborn infants admitted within 24 hours of birth.
- Serum ferritin levels were measured from venous blood samples at admission.
- Multivariable analysis was employed to identify independent predictors of serum ferritin, adjusting for sex and birth weight.
Main Results:
- The median serum ferritin level was 149 µg/L (IQR: 81-236) in the study population (36.2 ± 2.8 weeks gestation, 2319 ± 623 g birth weight).
- Hemoglobin, lactate dehydrogenase, blood pH, and maternal hypertensive disorders were significant independent variables associated with serum ferritin levels (p < 0.01).
- Serum ferritin levels in hospitalized infants were comparable to those reported for umbilical cord blood.
Conclusions:
- Serum ferritin levels in hospitalized newborns are influenced by factors including hemoglobin, lactate dehydrogenase, blood pH, and maternal hypertensive disorders.
- The observed associations suggest that antenatal hypoxia-ischemia and stress may impact serum ferritin levels in neonates.
- These findings provide novel insights into the determinants of iron status in sick hospitalized infants, aiding in clinical interpretation.
Abstract:
Both iron excess and deficiency are deleterious to cellular and organ homeostasis. Serum ferritin levels serve as a biomarker of iron storage; however, their distribution and determinants in sick newborn infants remain unclear. This study aimed to investigate the reference range and independent variables of serum ferritin in hospitalized newborn infants. All newborn infants who were hospitalized at a tertiary neonatal center within 24 h of birth were retrospectively reviewed for the period of April 2015 through March 2017. Serum ferritin levels were assessed using venous blood samples obtained at admission and their independent variables were explored. The study population comprised 368 infants (36.2 ± 2.8 weeks gestation and 2319 ± 623 g at birth), whose median serum ferritin level was 149 µg/L (inter-quartile range: 81-236). The multivariable model used to explain serum ferritin values comprised hemoglobin, lactate dehydrogenase, blood pH, and maternal hypertensive disorders in pregnancy (all p < 0.01, adjusted for sex and birth weight). Serum ferritin values in hospitalized newborn infants were comparable to those previously reported using umbilical cord blood. Our novel findings indicated the association between blood pH, lactate dehydrogenase, and ferritin levels, suggesting the influence of antenatal hypoxia-ischemia and stress to serum ferritin levels.
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