Estudio prospectivo y randomizado de suplementación de hierro temprana versus tardía en niños con peso al nacer menor de 1.301 g

Abstract

ABSTRACT Prospective randomized study of early versus late enteral iron supplementation in children who weighed < 1,301 grams at birth Objective: Determine whether early iron supplementation would decrease the need, the number and volume of transfused red blood cells in relation to late iron supplementation in children with birth weight less than 1,301 g. Patients and Methods: Very low birth weight (VLBW) infants were randomly assigned to receive early iron supplementation of 3 mg/kg/day as soon as they could tolerate enteral feeding of 100 ml/kg/day, or at 61 days of life as late supplementation. Hemoglobin levels were measured at the beginning of early iron supplementation and at 2 months of age. The red blood cell transfusion was performed according to transfu-sion guidelines and erythropoietin was not administered. Results: No differences were observed regarding the number of red cell transfusions between the groups. Morbidities associated with prematurity presented no significant differences. Conclusions: Early iron supplementation to a child that is tolerating 100 mL/kg/day of milk, does not decrease the incidence of red blood cell transfusions compared to late start iron at 61 days of life, and it is probably safe in infants with birth weight < 1,301 g.(Key words: Anemia, prematurity, ferrous sulfate, transfusion, red blood cells).Rev Chil Pediatr 2013; 84 (4): 379-386RESUMENObjetivo: Determinar si la suplementacion temprana de hierro disminuye la necesidad, el numero y volumen de globulos rojos transfundidos, en relacion a la suplementacion tardia de hierro en ninos con peso de naci-miento menor a 1.301 g. Pacientes y Metodo: Recien nacidos de muy bajo peso (RNMPN) fueron randomi-zados a recibir suplementacion temprana de hierro de 3 mg/kg/dia, tan pronto estaban tolerando alimentacion