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Serum Ferritin Levels in Very Preterm Infants Receiving Erythrocyte Transfusions: A Retrospective Study
Arathy Vijay1, Zubair Ahmad Bhat1, Femitha Pournami2
1Department of Neonatology, KIMS Health, Trivandrum, Kerala, India.
Insights
Very preterm infants receiving red blood cell transfusions (RBCT) face iron overload risks. Over half showed high iron levels, with multiple transfusions linked to excess iron, impacting supplementation timing.
Area of Science:
- Neonatal intensive care
- Pediatric hematology
- Nutritional science
Background:
- Very preterm infants frequently require red blood cell transfusions (RBCT) in neonatal intensive care.
- These infants are susceptible to iron overload due to transfusions and limited iron stores.
- Assessing iron status is crucial for managing these vulnerable neonates.
Purpose of the Study:
- To evaluate iron status in very preterm infants who underwent RBCT.
- To determine the association between the number of RBCT and iron excess.
- To inform optimal timing for initiating oral iron supplementation.
Main Methods:
- Retrospective review of 65 very preterm neonates requiring at least one RBCT.
- Serum ferritin levels were measured at 4-6 weeks of age, prior to oral iron initiation.
- Statistical analysis to identify factors associated with elevated ferritin levels.
Main Results:
- 52.3% (n=34) of neonates exhibited high serum ferritin levels, indicating iron excess.
- A need for more than one RBCT was significantly and independently associated with iron excess (P < 0.001).
- Elevated ferritin levels were observed in the neonatal period post-transfusion.
Conclusions:
- A significant proportion of very preterm infants receiving RBCT develop iron excess.
- The number of transfusions is a key predictor of iron overload in this population.
- Findings suggest careful consideration of transfusion history when timing iron supplementation.
Abstract:
Very preterm infants often need red blood cell transfusions (RBCT) during intensive care and are at risk of iron overload. This study reviewed the records of 65 very preterm neonates who required at least one RBCT to ascertain the iron status using serum ferritin levels at 4-6 weeks age before oral iron was commenced. High serum ferritin level was found in 52.3% (n = 34) neonates. Need for > 1RBCT was significantly and independently associated with iron excess (P < 0.001). Increased ferritin noted following transfusions in neonatal period can have implications for determining the appropriate time for starting iron supplementation in this subgroup of neonates.
