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Detección de deficiencia de hierro con contenido de hemoglobina de reticulocitos y resultados del neurodesarrollo a 2
Whitley N Hulse1,2, Timothy M Bahr2,3, Betsy Ostrander4
1Division of Neonatology and Newborn Nursery, Department of Pediatrics, University of Wisconsin, Madison, Wisconsin, United States.
Abstract:
The objective of this study is to assess reticulocyte-hemoglobin (RET-He) and daily iron dosing with 2-year cognitive outcomes.A multicenter retrospective cohort study of 78 infants born between 2014 and 2018 at less than 28 weeks' gestation or less than 1,250 g birth weight throughout level III or IV neonatal intensive care units (NICUs). RET-He measurement, iron supplementation, and the Bayley Scales of Infant and Toddler Development-III (Bayley-III) test were analyzed using multiple linear regression models.For every 1 mg/kg increase in mean total daily iron supplementation, the Bayley-III cognitive score increased by 2.9 points (95% confidence interval [CI]: 0.4-5.4, p = 0.023). No associations were identified between minimum or maximum RET-He and Bayley-III cognitive outcomes. Infants with a RET-He value < 29 pg tended to be 2.53 times more likely to have a Bayley-III language score below 70 (odds ratio: 2.53, 95% CI: 0.92-6.95, p = 0.071). Thirty-eight out of 78 (38.4%) infants were iron-deficient during their NICU hospitalization, with at least one RET-He < 29 pg.An association was identified between a higher mean daily iron dose and improved cognitive outcomes for infants, but not between the iron index RET-He and neurodevelopmental outcomes. Iron deficiency remains common among NICU patients undergoing follow-up, suggesting that standard iron dosing may be inadequate for high-risk neonates. · Higher daily iron dose improves cognitive outcomes.. · Reticulocyte-hemoglobin level is not associated with neurodevelopmental outcomes.. · Iron deficiency is common in very low birth weight infants, affecting 38.4%..

