Abstract
Iron stores at birth are essential to meet iron needs during the first 4–6 months of life. The present study aimed to investigate iron stores in normal birth weight, healthy, term neonates. Umbilical cord blood samples were collected from apparently normal singleton vaginal deliveries (n=854). Subjects were screened and excluded if C-reactive protein (CRP) > 5 mg/l or α1-acid glycoprotein (AGP) > 1 g/l, preterm (<37 complete weeks), term < 2500g or term > 4000g. In total, 762 samples were included in the study. Serum ferritin, soluble transferrin receptor (sTfR), hepcidin, and erythropoietin (EPO) were measured in umbilical cord blood samples; total body iron (TBI) (mg/kg) was calculated using sTfR and ferritin concentrations. A total of 19.8% newborns were iron deficient (ferritin 35 μg/l) and an additional 46.6% had insufficient iron stores (ferritin < 76 μg/l). There was a positive association between serum ferritin and sTfR, hepcidin, and EPO. Gestational age was positively associated with ferritin, sTfR, EPO, and hepcidin. In conclusion, we demonstrate a high prevalence of insufficient iron stores in a Chinese birth cohort. The value of cord sTfR and TBI in the assessment of iron status in the newborn is questionable, and reference ranges need to be established.
Highlights
Sufficient iron stores at birth support optimal development of the brain and nervous system during early infancy [1]
The present study aimed to investigate the concentrations of serum ferritin, soluble transferrin receptor (sTfR), hepcidin, and EPO in cord blood samples in a cohort of singleton vaginal birth full-term normal birth weight infants, using C-reactive protein (CRP) and α1-acid glycoprotein (AGP) to screen for both acute and chronic inflammation
A total of 854 cord samples were collected, none of the samples had CRP > 5 mg/l but 3 subjects had AGP > 1 g/l, 73 of the infants were delivered before 37 completed weeks of gestation, 5 term infants had a birth weight < 2500 g, and 11 had birth weight > 4000 g
Summary
Sufficient iron stores at birth support optimal development of the brain and nervous system during early infancy [1]. Little attention has been focused on the assessment of iron status at birth because of the belief that normal birth weight, healthy, term infants are born with sufficient iron stores to facilitate growth and metabolism during the first 6 months of life [2]. Serum ferritin concentrations are recommended as the primary measure of iron status at the population-level, levels may be affected by inflammation [4]. Studies have suggested thresholds for iron insufficiency (ferritin < 76 μg/l) [5] and iron deficiency (
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