The modern view on the problem subsidies iron in preterm infants

Abstract

Iron deficiency is estimated to range between 25% and 80% in preterms during infancy. Iron deficiency in infancy is associated with a range of clinical and neurodevelopmentally important issues including abnormalities of behavior. Low birth weight infants are particularly susceptible to developing iron deficiency anemia since they typically have small iron stores at birth and a greater need for iron. Unless augmented by external sources, the endogenous iron stores of preterm infants at birth meet their iron demands only until the doubling of the birth weight, i.e., approximately until 2–3 months of age. Due the potential adverse impact of iron deficiency on developing organ systems, preventive measures appear to be crucial.The need for iron therapy in preterm infants has been debated at least since the 1950s. But there are wide variations in iron supplementation practices among neonatal units. Numerous studies over the last decade differ somewhat in assessing the effectiveness of subsidies iron premature babies and in need of scientific reasoning. In summary, the preterm infant is at risk of both iron deficiency and iron overload. There is a paucity of information on the long-term effects of iron supplementation on hematological and non-hematological parameters, such as growth and neurodevelopment. Тhe potential for organ injury with excess iron suggests that therapy should be instituted carefully in the preterm infants. There are wide variations in the dose, initiation and duration of supplementation and iron compounds used for enteral supplementation. An important issue is also the the choice of drug for grants elemental iron. It was proved higher efficiency of trivalent iron administration which is more fast stabilization of hematological indices and reduces the need of blood transfusions.The article provides an overview of the available preventive recommendations enteral administration of iron premature babies. Randomized controlled trials are needed to determine whether iron supplementation in low birth weight/premature infants affects neurodevelopment (short and long term) and long term growth, and to comprehensively monitor potential adverse effects. Such studies should also aim to determine if specific cohorts of low birth weight / premature infants are more likely to benefit from iron supplementation, and the optimal dose, timing, and duration of iron supplementation.