The Iron Status of Very Low Birth Weight Infants Receiving Multiple Erythrocyte Transfusions during Hospitalization in the Neonatal Intensive Care Unit
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: We investigated the iron status of very low birth weight infants receiving multiple erythrocyte transfusions during hospitalization in the neonatal intensive care unit (NICU).Methods: We enrolled 46 very low birth weight infants who were admitted to the Kyungpook National University Hospital between January 2012 and December 2013. Serum ferritin was measured on their first day of life and weekly thereafter. We collected individual data of the frequency and volume of erythrocyte transfusion and the amount of iron intake.Results: A total of 38 (82.6%) of very low birth weight infants received a mean volume of 99.3±93.5 mL of erythrocyte transfusions in NICU. The minimum and maximum serum ferritin levels during hospitalization were 146.2±114.9ng/mL and 456.7±361.9 ng/mL, respectively. The total volume of erythrocyte transfusion was not correlated to max-imum serum ferritin concentrations after controlling for the amount of iron intake (r=0.012, p=0.945). Non-transfused infants took significantly higher iron intake compared to infants receiving ≥100 mL/kg erythrocyte transfusion (p＜0.001). Minimum and maximum serum ferritin levels of non-transfused infants were higher than those of infants receiving ＜100 mL/kg erythrocyte transfusions (p=0.026 and p=0.022, respectively). Infants with morbidity including broncho-pulmonary dysplasia or retinopathy of prematurity received a significantly higher volume of erythrocyte transfusions compared to infants without morbidity (p＜0.001).Conclusion: Very low birth weight infants undergoing multiply erythrocyte transfusions had excessive iron stores and non-transfused infants also might had a risk of iron overload during hospitalization in the NICU.
Abstract
Purpose: We investigated the iron status of very low birth weight infants receiving multiple erythrocyte transfusions during hospitalization in the neonatal intensive care unit (NICU).Methods: We enrolled 46 very low birth weight infants who were admitted to the Kyungpook National University Hospital between January 2012 and December 2013. Serum ferritin was measured on their first day of life and weekly thereafter. We collected individual data of the frequency and volume of erythrocyte transfusion and the amount of iron intake.Results: A total of 38 (82.6%) of very low birth weight infants received a mean volume of 99.3±93.5 mL of erythrocyte transfusions in NICU. The minimum and maximum serum ferritin levels during hospitalization were 146.2±114.9ng/mL and 456.7±361.9 ng/mL, respectively. The total volume of erythrocyte transfusion was not correlated to max-imum serum ferritin concentrations after controlling for the amount of iron intake (r=0.012, p=0.945). Non-transfused infants took significantly higher iron intake compared to infants receiving ≥100 mL/kg erythrocyte transfusion (p＜0.001). Minimum and maximum serum ferritin levels of non-transfused infants were higher than those of infants receiving ＜100 mL/kg erythrocyte transfusions (p=0.026 and p=0.022, respectively). Infants with morbidity including broncho-pulmonary dysplasia or retinopathy of prematurity received a significantly higher volume of erythrocyte transfusions compared to infants without morbidity (p＜0.001).Conclusion: Very low birth weight infants undergoing multiply erythrocyte transfusions had excessive iron stores and non-transfused infants also might had a risk of iron overload during hospitalization in the NICU.
참고문헌 (24)
- Dallman PR, "Biochemical basis for the manifestations of iron deficiency", Annu Rev Nutr, 6, pp.13~40 (1986)
- Singla PN, "Storage iron in human foetal organs", Acta Paediatr Scand, 74, pp.701~706 (1985)
- Shaw JC, "Iron absorption by the premature infant. The effect of transfusion and iron supplements on the serum ferritin levels", Acta Paediatr Scand Suppl, 299, pp.83~89 (1982)
- Widness JA, "Changing patterns of red blood cell transfusion in very low birth weight infants", J Pediatr, 129, pp.680~687 (1996)
- Sullivan JL, "Iron, plasma antioxidants, and the 'oxygen radical disease of prematurity'", Am J Dis Child, 142, pp.1341~1344 (1988)
- Rao R, "Iron therapy for preterm infants", Clin Perinatol, 36, pp.27~42 (2009)
- Cooke RW, "Blood transfusion and chronic lung disease in preterm infants", Eur J Pediatr, 156, pp.47~50 (1997)
- Inder TE, "High iron status in very low birth weight infants is associated with an increased risk of retinopathy of prematurity", J Pediatr, 131, pp.541~544 (1997)
- Dorea JG, "Iron and copper in human milk", Nutrition, 16, pp.209~220 (2000)
- Jobe AH, "Bronchopulmonary dysplasia", Am J Respir Crit Care Med, 163, pp.1723~1729 (2001)
- Siddappa AM, "The assessment of newborn iron stores at birth: a review of the literature and standards for ferritin concentrations", Neonatology, 92, pp.73~82 (2007)
- Messer RD, "Serum ferritin in term and preterm infants", Aust Paediatr J, 16, pp.185~188 (1980)
- Mukhopadhyay K, "Iron status at birth and at 4 weeks in preterm-SGA infants in comparison with preterm and term-AGA infants", J Matern Fetal Neonatal Med, 25, pp.1474~1478 (2012)
- Singla PN, "Fetal iron status in maternal anemia", Acta Paediatr, 85, pp.1327~1330 (1996)
- Chockalingam UM, "Cord transferrin and ferritin values in newborn infants at risk for prenatal uteroplacental insufficiency and chronic hypoxia", J Pediatr, 111, pp.283~286 (1987)
- Georgieff MK, "Abnormal iron distribution in infants of diabetic mothers: spectrum and maternal antecedents", J Pediatr, 117, pp.455~461 (1990)
- Arad I, "Serum ferritin levels in preterm infants after multiple blood transfusions", Am J Perinatol, 5, pp.40~43 (1988)
- Bard H, "The life span of erythrocytes transfused to preterm infants", Pediatr Res, 42, pp.9~11 (1997)
- Hirano K, "Blood transfusion increases radical promoting non-transferrin bound iron in preterm infants", Arch Dis Child Fetal Neonatal Ed, 84, pp.F188~193 (2001)
- Jacobs A, "Ferritin: an interim review", Curr Top Hematol, 5, pp.25~62 (1985)
- Zhuang T, "Iron, oxidative stress and gestational diabetes", Nutrients, 6, pp.3968~3980 (2014)
- Knutson MD, "Both iron deficiency and daily iron supplements increase lipid peroxidation in rats", J Nutr, 130, pp.621~628 (2000)
- Lachili B, "Increased lipid peroxidation in pregnant women after iron and vitamin C supplementation", Biol Trace Elem Res, 83, pp.103~110 (2001)
- Romagnoli C, "Do recombinant human erythropoietin and iron supplementation increase the risk of retinopathy of prematurity?", Eur J Pediatr, 159, pp.627~628 (2000)