Abstract
To assess the association between iron status at birth and growth of preterm infants. Ninety-five premature babies (26 to 36 weeks of gestational age) born from July 2000 to May 2001 in a public hospital in Rio de Janeiro, Southeastern Brazil, were followed up for six months, corrected by gestational age. Iron measurements at birth were available for 82 mothers and 78 children: hemoglobin, hematocrit, mean corpuscular volume and plasma iron. All children received free doses of iron supplement (2 mg/kg/day) during the follow-up period and up to two years of age. Multivariate linear regression analyses with repeated measurements were performed to assess factors associated to linear growth. Growth was more pronounced up to 40 weeks of gestational age, increasing about 1.0 cm/week and then slowing down to 0.75 cm/week. The multivariate analysis showed growth was positively associated with birth weight (0.4 cm/100 g; p<0.001) and negatively associated with gestational age at birth (-0.5 cm/week; p<0.001). There was no association between cord iron and mother iron measurements and growth (p>0.60 for all measures). Only two children had anemia at birth, whereas 43.9% of mothers were anemic (hemoglobin <11 g/dl). Also, there was no correlation between anemia indicators of mothers and children at birth (r<0.15; p>0.20). Maternal anemia was not associated with anemia in preterm infants and iron status of mothers and children at birth was not associated with short-term growth of preterm infants.
Highlights
Anemia is a highly prevalent disease in Brazil.[15]
The multivariate analysis showed growth was positively associated with birth weight (0.4 cm/100 g; p≤0.001) and negatively associated with gestational age at birth (-0.5 cm/week; p≤0.001)
Maternal anemia was not associated with anemia in preterm infants and iron status of mothers and children at birth was not associated with shortterm growth of preterm infants
Summary
Anemia is a highly prevalent disease in Brazil.[15]. enriching cereal products with iron became mandatory in 2002, pregnant women from low socioeconomic groups still lack iron supplements on a regular basis. Disease burden among those LBW infants depends on their growth pattern.[12] In a population-based cohort study conducted in Southern Brazil comprising 3,582 children examined at birth, 20 and 42 months of age, catch-up growth from zero to 20 months was related to subsequent risks of hospital admissions and mortality, and those children who were small-for-gestational-age but presented substantial weight gain (≥0.66 z-score) up to the age of 20 months had 65% fewer subsequent hospital admissions than the other small-for-gestational-age babies.[23] These rapid-growing children had admission and mortality rates similar to those observed for children born with adequate birth weight for their gestational age These findings suggest that growth promotion efforts for preterm babies may have at least short-term benefits
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