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Serum transferrin receptor levels in the evaluation of iron deficiency in the neonate
1Department of Pathology, University College of Medical Sciences, Shahdara, Delhi, India.
Insights
Serum transferrin receptor (STFR) levels effectively identify iron deficiency in newborns. This sensitive measure helps detect iron deficient erythropoiesis in neonates, addressing a critical global health issue.
Area of Science:
- Neonatal Medicine
- Hematology
- Nutritional Science
Background:
- Iron deficiency anemia (IDA) is a significant global health concern, particularly impacting neonates in developing nations.
- Conventional iron status markers often lack sensitivity in identifying iron deficiency in early neonatal stages.
- Early detection of iron deficiency in neonates is crucial for preventing long-term health complications.
Purpose of the Study:
- To evaluate the utility of cord serum transferrin receptor (STFR) levels in identifying iron deficient erythropoiesis in neonates.
- To compare STFR levels with traditional iron status parameters in neonates and their mothers.
- To determine if STFR can differentiate neonates born to iron-deficient mothers from those born to non-anemic mothers.
Main Methods:
- A study involving 100 full-term neonates and their mothers at parturition.
- Assessed complete hemogram, red cell indices, serum iron (SI), transferrin saturation (TS%), and serum ferritin (SF).
- Measured cord and maternal STFR levels using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Maternal anemia correlated with lower SI, TS%, and higher STFR, indicating iron deficiency.
- Neonatal iron profiles (SI, TS%, ferritin) did not significantly differ between infants of anemic and non-anemic mothers.
- Cord STFR levels correlated with hemoglobin and iron status parameters, and were significantly higher in neonates of anemic mothers.
Conclusions:
- Cord serum transferrin receptor (STFR) is a sensitive indicator of neonatal iron status.
- STFR levels effectively differentiate neonates with iron deficient erythropoiesis, even when traditional markers are inconclusive.
- This finding highlights STFR's potential as a key diagnostic tool for neonatal iron deficiency.
Abstract:
Iron deficiency anemia (IDA) is a major global problem. Early onset of iron deficiency in developing countries makes it imperative to identify iron deficiency in neonates. Most conventional laboratory parameters of iron status fail to distinguish neonates with iron deficient erythropoiesis. Serum transferrin receptor (STFR) levels are a recent sensitive measure of iron deficiency and the present study was carried out to evaluate the usefulness of cord serum transferrin receptors in identifying iron deficient erythropoiesis in neonates. A complete hemogram, red cell indices, iron profile: serum iron (SI), percent transferrin saturation (TS%) and serum ferritin (SF) was carried out in 100 full-term neonates and their mothers at parturition. Cord and maternal STFR levels were estimated using a sensitive enzyme-linked immunosorbent assay (ELISA) technique. Anemic women had a significantly lower SI, their TS% and high STFR levels suggesting that iron deficiency was responsible for the anemia. In the neonates of iron deficient mothers, cord SI, TS% and cord ferritin were not significantly different from those of neonates born to non-anemic mothers. Cord STFR level correlated well with hemoglobin (Hb) and laboratory parameters of iron status, and its level was significantly higher in neonates born to anemic mothers than in those born to non-anemic mothers. It was the only laboratory parameter to differentiate between neonates born to anemic and non-anemic mothers. Therefore, STFR is a sensitive index of iron status in neonates and identifies neonates with iron deficient erythropoiesis.