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Biomarkers of Brain Dysfunction in Perinatal Iron Deficiency
1Division of Neonatology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
Insights
Perinatal iron deficiency negatively impacts infant neurodevelopment. A biomarker-based approach, rather than universal supplementation, is needed to optimize brain development and prevent iron deficiency complications.
Area of Science:
- Pediatrics
- Neuroscience
- Biochemistry
Background:
- Perinatal iron deficiency poses significant risks to infant neurodevelopment.
- Current universal iron supplementation strategies may lead to undertreatment or overtreatment, focusing on hematological normalization rather than optimal brain development.
Purpose of the Study:
- To advocate for a revised screening and treatment strategy for perinatal iron deficiency.
- To emphasize the need for a focus on optimizing neurodevelopment in affected infants.
Main Methods:
- Review of current pediatric society recommendations for iron supplementation.
- Analysis of serum iron indices and hematological parameters as potential biomarkers for neurodevelopmental risk.
- Evaluation of the limitations of current universal supplementation approaches.
Main Results:
- Existing universal iron supplementation strategies do not account for individual iron status variations.
- Certain serum iron and hematological markers in the perinatal period are linked to neurodevelopmental risks.
- These biomarkers suggest potential for targeted screening and monitoring.
Conclusions:
- A biomarker-based screening and treatment strategy is necessary for perinatal iron deficiency.
- Such a strategy, focused on optimizing brain development, is likely to improve infant outcomes.
- Individualized approaches are superior to universal supplementation for managing perinatal iron deficiency.
Abstract:
Iron deficiency in the fetal and neonatal period (perinatal iron deficiency) bodes poorly for neurodevelopment. Given its common occurrence and the negative impact on brain development, a screening and treatment strategy that is focused on optimizing brain development in perinatal iron deficiency is necessary. Pediatric societies currently recommend a universal iron supplementation strategy for full-term and preterm infants that does not consider individual variation in body iron status and thus could lead to undertreatment or overtreatment. Moreover, the focus is on hematological normalcy and not optimal brain development. Several serum iron indices and hematological parameters in the perinatal period are associated with a risk of abnormal neurodevelopment, suggesting their potential use as biomarkers for screening and monitoring treatment in infants at risk for perinatal iron deficiency. A biomarker-based screening and treatment strategy that is focused on optimizing brain development will likely improve outcomes in perinatal iron deficiency.
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