1080 Iron Status at Birth in Term Small-Forgestational Age Infants

Abstract

Objectives: To determine body iron stores at birth in term small-for-gestational age (SGA) infants as compared to appropriate-for-gestational age (AGA) infants. Design: Prospective cohort study. Setting: Level III neonatal unit. Patients: Mother infant pairs with gestation of ≥37 weeks and birth weight of at least 1.5 kg were enrolled. Asymmetric SGA infants were taken as cases and gestation matched AGA infants as controls. Maternal and cord blood samples and infant blood samples during follow up were obtained for measurement of various iron indices. Outcomes: Primary- cord serum ferritin at birth, Secondary- proportion of infants with ‘low’ ferritin, serum ferritin in followup, and correlation among maternal and neonatal iron indices - Hb, serum Iron and total Iron binding capacity (TIBC). Results: There were 50 SGA and 50 AGA motherinfant pairs. Cord serum ferritin levels were less in SGA group as compared to AGA group [median (IQR): 68 (30,136) vs. 141 (63,259), p=0.007]. The proportion of infants with ‘low’ cord ferritin (defined as < 40 µg/L) were more in SGA group [17 (34%) vs. 9 (18%) in AGA group, p= 0.05]. Other iron indices were similar in both the groups. There was no correlation among various maternal and neonatal cord iron parameters. The serum ferritin levels at 28±3 days of age were also less in SGA group with a trend towards significance (p=0.06). Conclusions: Term asymmetric SGA infants have lesser total iron stores as compared to gestation matched AGA infants at birth. Implications: SGA infants need iron supplementation starting from early infancy.