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Developmental Trends in Serum Iron, Transferrin, and Transferrin Saturation From Birth to 12 Months

Sara Marie Larsson1,2, Lena Hellström-Westas3, Ulrica Askelöf4

  • 1Department of Clinical Chemistry, Halland Hospitals, Varberg, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|April 27, 2026
PubMed

Insights

Delayed cord clamping (DCC) in infants influences iron status biomarkers. Updated reference intervals are crucial for accurate interpretation of iron, transferrin, and transferrin saturation in the first year of life.

Area of Science:

  • Pediatric Hematology
  • Neonatal Physiology
  • Clinical Biochemistry

Background:

  • Infant iron status assessment requires up-to-date reference intervals.
  • Delayed cord clamping (DCC) is a common practice influencing neonatal iron levels.
  • Understanding iron biomarker trends in infancy is critical for clinical management.

Purpose of the Study:

  • To establish reference interval trends for iron, transferrin, and transferrin saturation in infants born after DCC.
  • To investigate diurnal variations in iron status biomarkers in early infancy.
  • To provide updated data for interpreting iron status in infants.

Main Methods:

  • Analysis of data from 362 term-born infants undergoing DCC (≥60s).
  • Serum samples collected at birth (cord blood), 48-118 hours, 4 months, and 12 months.
  • Calculation of 2.5th and 97.5th percentiles; Spearman's rho and Student's t-test used for analysis.

Main Results:

  • Cord blood iron was high, decreasing by 48-118 hours and stabilizing.
  • Transferrin levels were initially low, increasing gradually and correlating with weight gain.
  • A minor diurnal variation in iron was noted at 48-118 hours.

Conclusions:

  • Infant iron, transferrin, and transferrin saturation levels exhibit distinct developmental trends.
  • Reference intervals must account for these trends for accurate interpretation.
  • DCC impacts iron status, necessitating updated pediatric reference ranges.
Abstract

Keywords:
circadian rhythmdelayed cord clampingdiurnal variationhypoferremiapaediatric reference intervals

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