Contemporary views concerning the necessity, age of indication and duration of iron administration to prevent deficiency and to treat iron-deficiency anemia in infants

Abstract

Nowadays deficiency of micronutrients leading to the development of serious disorders in the human organism remains an important problem to be solved in the world. Anemia is considered to be one of such problems which is an indicator of the quality of diet and the sate of human heath. About 70-80% cases of diagnosed anemia are connected with iron deficiency. Iron-deficiency anemia may occur in any place, season of the year and age. Although pregnant women and newborns, especially preterm ones are the most susceptible to the development of anemia. The article specifies explanations concerning the importance of iron intake by the fetus in the III trimester of pregnancy and the importance of iron effect upon an adequate development of fetus and babies in the first 2 years of life. Perinatal risk factors are indicated which cause 20% of development of iron-deficiency conditions and pathophysiological reasons of a negative influence of these conditions on the CNS. Using the findings of the unified protocol project “Enteral Feeding of Preterm Infants” and results of the studies investigating the influence of iron preparations upon the development of infants, CNS state, hematological status, the age to indicate iron preparations, daily doses and duration of their administration are discussed.Attention is focused on the advantages to administer oral forms of ferric iron (drops, syrup “Maltofer”) for infants. The method to calculate a daily amount of iron preparation is demonstrated individually for every child, being aware of a therapeutic dose of an elementary iron in 1 ml of preparation. The analysis of the studies existed from 1960-2010 enables to conclude that administration of iron preparations in newborns and infants of various gestational age improve the indices of iron hematological status and reduce the frequency of development of iron deficiency and iron-deficiency anemia. Till now there is a necessity to conduct randomized controlled trials with the aim to get essential evidence concerning the consequences of iron preparation effect upon the development of the nervous system or occurrence of unfavourable effects in preterm newborns, especially in infants with very low body weight at birth.The optimum dose, the term of the beginning and duration of the administration of ferric iron use indicated for intravenous injection are defined: gestational age of a baby, hematological indices (the level of hemoglobin, serum ferritin, mean corpuscular volume), the aim achieved (prevention of iron deficiency or treatment of iron-deficiency anemia).