Effects Of Iron Deficiency Research Articles

Iron deficiency and soil-transmitted helminth infection: classic and neglected connections.

Beyond participating in the oxygen transport by red blood cells, iron is an essential micronutrient and contributes to different physiological pathways and processes, such as cell proliferation, DNA repair, and other homeostatic functions. Iron deficiency affects millions of people, especially children and pregnant women. The consequences of iron deficiency are diverse, including inadequate child development, impaired cognition, and reduced productivity. Several factors contribute to iron deficiency, such as iron-poor diet, genetic factors, and infection with soil-transmitted helminths (STHs), especially roundworms (Ascaris lumbricoides), hookworms (Necator americanus and Ancylostoma duodenale), and whipworms (Trichuris trichiura). This review updates and summarizes the role of STHs as drivers of iron deficiency. Also, the poorly explored connections between STH infection, geophagia (a pica manifestation), immune response, and iron deficiency are discussed, highlighting how iron deficiency may act as a risk factor for infections by STHs, in addition to being a consequence of intestinal parasitic infections. Finally, strategies for control and management of iron deficiency and STH infection are described.

Iron Deficiency in Heart Failure and Effect of Dapagliflozin: Findings From DAPA-HF.

Background:Iron deficiency is common in heart failure and associated with worse outcomes. We examined the prevalence and consequences of iron deficiency in the DAPA-HF trial (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure) and the effect of dapagliflozin on markers of iron metabolism. We also analyzed the effect of dapagliflozin on outcomes, according to iron status at baseline.Methods:Iron deficiency was defined as a ferritin level <100 ng/mL or a transferrin saturation <20% and a ferritin level 100 to 299 ng/mL. Additional biomarkers of iron metabolism, including soluble transferrin receptor, erythropoietin, and hepcidin were measured at baseline and 12 months after randomization. The primary outcome was a composite of worsening heart failure (hospitalization or urgent visit requiring intravenous therapy) or cardiovascular death.Results:Of the 4744 patients randomized in DAPA-HF, 3009 had ferritin and transferrin saturation measurements available at baseline, and 1314 of these participants (43.7%) were iron deficient. The rate of the primary outcome was higher in patients with iron deficiency (16.6 per 100 person-years) compared with those without (10.4 per 100 person-years; P<0.0001). The effect of dapagliflozin on the primary outcome was consistent in iron-deficient compared with iron-replete patients (hazard ratio, 0.74 [95% CI, 0.58–0.92] versus 0.81 [95% CI, 0.63–1.03]; P-interaction=0.59). Similar findings were observed for cardiovascular death, heart failure hospitalization, and all-cause mortality. Transferrin saturation, ferritin, and hepcidin were reduced and total iron-binding capacity and soluble transferrin receptor increased with dapagliflozin compared with placebo.Conclusions:Iron deficiency was common in DAPA-HF and associated with worse outcomes. Dapagliflozin appeared to increase iron use but improved outcomes, irrespective of iron status at baseline.Registration:URL: https://www.clinicaltrials.gov; Unique identifier: NCT03036124.

Cut off Value of Red Cell Distribution Width (RDW) in Screening and Diagnosis of Iron Deficiency Anemia and b Thalassemia Trait

Background: The most concerning consequences of iron deficiency in children are the alterations of cognitive, motor, and behavioral performance. Persistent neurocognitive changes despite iron repletion have increased the importance of prevention and early detection of iron deficiency.&#x0D; Objectives: To evaluate the cut off value of red cell distribution width (RWD) in the screening and diagnosis of iron deficiency anemia (IDA) and â thalassemia trait (BTT).&#x0D; Methods: It is a cross sectional study performed at Dhaka Shishu (Children) Hospital from July 2006 to July 2008. Total 52 patients, age ranged from 1-12 years were included in the study. Among them 27 cases were IDA and 25 cases were BTT. Complete blood count (CBC), serum ferritin and hemoglobin (HB) electrophoresis were measured. The sensitivity, specificity, positive and negative predictive value of differential and cutoff value for RDW discrimination index in differentiation between IDA and BTT were performed.&#x0D; Results: Age ranged from 1-12 years. In IDA group male were found 16(59%), female were 11(41%) and in BTT group male were 15(60%), female were 10(40%). The Hb% value in IDA group was significantly (p&lt;0.0001) lower than value for BTT. An elevation of RBC distribution width (&gt;14.6) in IDA had a sensitivity of 81%, specificity of 84%, positive predictive value (PPV) of 85% and negative predictive value (NPV) of 81%; value of RBC distribution width (&lt;14.6) in BTT had a sensitivity of 84%, specificity of 81%, positive predictive value (PPV) of 81% and negative predictive value (NPV) of 85%. An elevation of RBC distribution width (&gt;16) had a sensitivity of 67%, specificity of 92%, and positive predictive value (PPV) of 90% in distinguishing iron deficiency anemia from thalassemia trait. Moreover, eleven (11) of 27 patients with iron deficiency had RBC distribution width values greater than 18 compared to one (1) of the patients with thalassemia trait. An elevation of RBC distribution width ³18 specificity of 96% and positive predictive value (PPV) of 92%.&#x0D; Conclusion: The rersult of the study, in patients with microcytic hypochromic anemia, RDW value e³14.6% and Hb level&lt; 10gm/dl, iron deficiency is the most likely diagnosis. RDW value (&gt;16) is a reliable diagnostic tool in differentiation between IDA and BTT. Red cell distribution width (RDW) above 16% is the best index of IDA.&#x0D; DS (Child) H J 2021; 37(1): 51-58

PERAN EDUKASI GIZI DALAM PENCEGAHAN ANEMIA PADA REMAJA DI INDONESIA: LITERATURE REVIEW

Anemia is still a health problem throughout the world, including Indonesia. Anemia in adolescents has a serious impact and is entirely a consequence of iron deficiency which is closely related to the severity of anemia. In addition, anemia in adolescent girls can increase the risk of developing anemia during pregnancy. This will have a negative impact on growth and the fetus in the womb, along with the development to experience a number of complications during pregnancy and during delivery. Anemia can be treated with various strategies, one of which is through nutrition education. This literature review study aims to provide an overview of various methods, media, roles and effectiveness of nutrition education in the context of preventing anemia in adolescents in Indonesia. The method used in this paper is a literature review study by searching Indonesian language articles through the Google Scholar database and Garuda Portal in the period 2018-2021. The keywords used are "nutrition education", "anemia", "teenagers". From the results of the search and study, 8 articles were obtained through Google Scholar and 2 articles through the Garuda Portal which were used for this research. The results showed that nutrition education played a role in preventing anemia in adolescent girls through several aspects, namely knowledge, attitudes and hemoglobin levels. Nutrition education can be done through a variety of media such as healthy millennial card, booklets, leaflets, posters, comics, flipcharts, motion videos, Whatsapp and Facebook delivered through a number of educational methods such as games, counseling, lectures, Team Game Tournament (TGT), peer group education and integrated education.

Pediatric Heart Failure: Cardiac Ejection Fraction with Cardiomyopathy Decreased to 21% in Iron Deficient from 37% in Iron Sufficient Children

▪Introduction: The overall aim of our study was to determine if iron deficiency has harmful effects on cardiac function in children with chronic heart failure. Heart failure in children is a complex, heterogeneous disorder leading to a final common pathway of cardiomyocyte dysfunction and attrition. Cellular, animal, and human studies have shown that iron deficiency causes cardiomyocyte dysfunction that can be reversed with iron treatment. Cellular studies of human iron-deficient cardiomyocytes have shown that supplemental iron restores impaired contractility and relaxation. Animal studies have found that cardiomyocyte-specific deletions or alterations of critical iron proteins (transferrin receptor 1, hepcidin, ferroportin) produce cardiomyocyte iron deficiency (without anemia) and result in ultimately fatal cardiac dysfunction that can be rescued with intravenous (IV) iron. Over half of adults with chronic heart failure are iron deficient. Meta-analysis of small randomized clinical trials has shown that IV iron significantly reduces recurrent hospitalization, cardiovascular mortality, and all-cause mortality in iron deficient adults with heart failure. European Society of Cardiology, American College of Cardiology and American Heart Association guidelines recommend consideration of IV iron therapy for adult iron-deficient patients with heart failure.The prevalence and consequences of iron deficiency in children with heart failure have not been established. Previously, two small retrospective studies of children with heart failure have reported that 56% to 96% were iron deficient, with increased morbidity and mortality. The goals of our study of children with heart failure were to determine (i) how often iron status is assessed, (ii) the prevalence of iron deficiency, and (iii) the effects of iron deficiency on cardiac function in patients with cardiomyopathy.Methods: We retrospectively reviewed electronic medical records to identify pediatric patients ages 1-21 years old seen at Columbia University Irving Medical Center Pediatric Heart Failure clinic with absolute iron deficiency during 2010-2020. Heart failure was defined as presence of symptoms or systolic dysfunction by echocardiography. Patients were excluded with a history of heart transplant, isolated diastolic failure, or renal failure requiring dialysis. In adults with heart failure, a transferrin saturation <20% has a sensitivity of 94% and a specificity of 84% in identifying absolute iron deficiency, as determined from a bone marrow aspirate, and iron stores were present in 100% of patients with a transferrin saturation ≥30% (Circ Heart Fail. 2018;11:e0045). In children with heart failure, we used these criteria to define absolute iron deficiency as a transferrin saturation <20% and iron sufficiency as a transferrin saturation ≥30%.Patients with an intermediate transferrin saturation are likely a mixture of absolute and functional iron deficiency, and of iron sufficiency and were excluded from our analysis of cardiomyopathy. Cardiac ejection fraction was evaluated by an echocardiogram performed within 3 months of measurement of transferrin saturation.Results: Of 579 patients with heart failure, only 159 (27%) had any type of laboratory iron studies. Of patients with iron studies, 81 (51%) were evaluated as outpatients; 49% as inpatients. The cause of heart failure was cardiomyopathy (52%), congenital heart disease (34%), acute myocarditis (6%), and other (8%).In the 82 patients with heart failure due to cardiomyopathy, 39 (48%) were iron deficient and 16 (20%) iron sufficient. In the iron deficient children with cardiomyopathy, the left ventricular ejection fraction was lower than in the iron sufficient patients (median 21% vs. 37%; p=0.03 (Mann-Whitney); Figure). The groups did not differ significantly with respect to hemoglobin (Figure), sex, age, or New York Heart Association class.Conclusion: We report a clinically important decrease in cardiac ejection fraction in children with heart failure due to cardiomyopathy who have absolute iron deficiency. Potentially, iron treatment could safely and effectively reverse the harmful effect of iron deficiency on heart function and prospective randomized trials of oral and intravenous iron therapy are urgently needed. Measurement of iron status should routinely be included in the evaluation of children with heart failure. [Display omitted] DisclosuresNeunert: Novartis: Research Funding.

Iron Fortification Practices and Implications for Iron Addition to Salt

This introductory article provides an in-depth technical background for iron fortification, and thus introduces a series of articles in this supplement designed to present the current evidence on the fortification of salt with both iodine and iron, that is, double-fortified salt (DFS). This article reviews our current knowledge of the causes and consequences of iron deficiency and anemia and then, with the aim of assisting the comparison between DFS and other common iron-fortified staple foods, discusses the factors influencing the efficacy of iron-fortified foods. This includes the dietary and physiological factors influencing iron absorption; the choice of an iron compound and the fortification technology that will ensure the necessary iron absorption with no sensory changes; encapsulation of iron fortification compounds to prevent unacceptable sensory changes; the addition of iron absorption enhancers; the estimation of the iron fortification level for each vehicle based on iron requirements and consumption patterns; and the iron status biomarkers that are needed to demonstrate improved iron status in populations regularly consuming the iron-fortified food.The supplement is designed to provide a summary of evidence to date that can help advise policy makers considering DFS as an intervention to address the difficult public health issue of iron deficiency anemia, while at the same time using DFS to target iodine deficiency.

Iron.

Iron deficiency anemia affects approximately one-third of the world's population, and about half the cases are due to iron deficiency. The latest research on iron metabolism published in original articles and systematic reviews is described, and references to recent reviews provided. The topics include dietary sources and bioavailability, iron homeostasis, functions of iron in the body, and biomarkers of status. The consequences of iron deficiency and excess are discussed, with particular focus on vulnerable populations such as pregnant women, infants and the elderly. The newest dietary recommendations, including dietary reference values and food based dietary guidelines, are briefly summarized, followed by the latest developments in food fortification and iron supplementation.

Iron Status Among Children Aged 6-17 Years by Serum Ferritin - China, 2016-2017.

What is already known on this topic?Iron deficiency (ID) is the most widespread micronutrient deficiency and have several adverse effects on health. Consequences of ID among children include delayed psychomotor development and impaired cognitive performance, which makes it important to monitor the iron status of children.What is added by this report?In this study, the serum ferritin (SF) level was 56.6 (95% CI: 56.0–57.2) ng/mL in 65,293 children aged 6–17 years old in the National Nutrition and Health Surveillance in China in 2016–2017. ID prevalence varied significantly in children stratified by sex, age, and regions ranging from 1.0% to 28.1% judged by the standard of SF<15 ng/mL and SF<25 ng/mL. ID prevalence in females aged 12–17 years was the highest among children aged 6–17 years.What are the implications for public health practice?Understanding iron status of school children could provide evidence and data for developing policies and strategies for ID and iron deficiency anemia (IDA) control and prevention. Females aged 12–17 years showed high ID prevalence, and iron-rich food interventions are strongly recommended.

Causes and consequences of iron deficiency without anemia in the practice of gynecologist

The effect of iron deficiency (ID) without anemia on the reproductive health of women in contrast to iron deficiency anemia is still insufficiently evaluated from a clinical point of view, despite a weighty theoretical basis and a large pool of clinical observations. The purpose of this review is to systematize the ID causes without anemia in women associated and not associated with reproductive disorders, the effects of ID without anemia on reproductive health, and modern approaches to the diagnosis and treatment of this pathology. ID without anemia affects most of the physiological processes in a woman's body, including hormonal regulation, immune processes and functions of the nervous system. The negative effect of ID without anemia on a woman's reproductive function is realized through hormone-mediated and immune mechanisms. ID without anemia is currently underestimated in terms of somatic and reproductive health of women, as well as quality of life. Сlinical manifestations of ID without anemia are mostly nonspecific, which is why clinicians, focusing only on hematological parameters are often explaining them by other reasons, which leads to late diagnosis. Assessment of hematological parameters alone is accompanied by significant underdiagnosis of ID without anemia. Diagnosis of ID without anemia should be carried out in women with risk factors (abnormal uterine bleeding, heavy menstrual bleeding, etc.), as well as with dyshormonal disorders, recurrent inflammatory processes in combination with ID symptoms by assessing the ferritin and transferrin saturation.To treat ID without anemia it is necessary to eliminate the etiological factor and carry out a sufficiently long-term supplementation with oral iron preparations with good tolerance and bioavailability. Iron bisglycinate is the form of iron intake that does not affect the mucous membrane of the gastrointestinal tract and is absorbed by the small intestine mucosa unchanged, which ensures its good tolerability and high efficiency for the correction of ID.

Abstract 14287: Iron Deficiency is Associated With More Severe Pulmonary Vascular Disease in Pulmonary Hypertension Due to Chronic Lung Disease

Background: Iron deficiency promotes pulmonary vascular remodeling in pre-clinical models, and is associated with worse outcomes in pulmonary arterial hypertension. However, the consequences of iron deficiency in patients with pulmonary hypertension due to chronic lung disease (Group 3 PH) are unexplored. Methods: We studied 122 consecutive Group 3 PH patients from the University of Minnesota Pulmonary Hypertension Repository. Serum soluble transferrin receptor (sTR) levels quantified iron deficiency. We evaluated the relationship between iron deficiency and pulmonary vascular disease, right ventricular (RV) function, exercise capacity, and survival. Results: The iron deficient group (&lt;4.8mg/L sTR) had significantly higher mean pulmonary arterial pressure (40±9 mmHg, n=59 vs. 44±13 mmHg, n=61; p =.02) and lower pulmonary arterial compliance (2.2±1.2 mL/mmHg, n=52 vs. 1.7±0.8 mL/mmHg, n=55; p =.01), but there was no difference in pulmonary vascular resistance. Moreover, there were trends for higher right atrial pressure (7±4 mmHg, n=58 vs. 9±6 mmHg, n=61; p =0.08) in iron deficient patients. However, iron deficiency did not significantly alter RV function by echocardiography, 6-minute walk distance, or survival. Conclusions: Iron deficiency in Group 3 PH is associated with worse pulmonary vascular disease. This suggests iron deficiency could contribute to pulmonary vascular disease in Group 3 PH, and future studies are needed to determine if iron replacement could be a therapy for this deadly type of PH.

Caregivers' knowledge and perception of iron content in common staple foods consumed in Southeastern Nigeria

Background: Iron-deficiency anemia remains a major cause of morbidity and mortality of children in our environment. The knowledge of its function and food-rich sources of iron among mothers and/or caregivers will go a long way to mitigate the growth and developmental consequences of iron deficiency in children. Methods: Due to the high prevalence of iron-deficiency anemia in our locality, we set out to determine the knowledge of mothers and/or caregivers of the richest source of iron among all staple foods commonly consumed in our locality and their awareness of cooking methods that degrade the dietary iron. This cross-sectional hospital study conducted over an 8-month period recruited and interviewed 407 mothers/caregivers attending the Children's Outpatient Clinic of the Enugu State University Teaching Hospital using illustrated self-administered questionnaires. Results: A vast majority (90.9%) were aware of dietary iron, but when further questioned about its source and function, almost all respondents (99.2%) considered unripe plantain as the richest food source of iron. None chose cowpea which contains the highest iron content. Likewise, none identified cooking practices that reduce dietary iron availability. Eighteen (4.4%) correctly recognized individuals at the highest risk for iron deficiency, whereas only 5 (2.4%) and 1 (0.3%), respectively, correctly selected all the correct functions of iron and ways it can be lost in the body. Conclusion: Respondents in our study have absolutely no knowledge of cowpea, the richest and cheapest sources of iron in our environment. There is consequently a need to create a comprehensive nutritional campaign, especially during antenatal and well-child clinic visits, to educate parents/caregivers on local and readily available iron-rich food sources and cooking practices while discouraging cooking practices that could potentially degrade elemental iron in these food sources.

Iron deficiency and iron treatment in the fetal developing brain \u2013 a pilot study introducing an experimental rat model

BackgroundIron deficiency is especially common in women during the reproductive age and it is estimated that 52% of pregnant women have iron deficiency anemia. Maternal iron deficiency with or without anemia in pregnancy may have consequences for the fetus, where it may have an impact on the cerebral development of the brain. Both animals and adult human studies support that iron deficiency affects psychomotor development, behavioral traits, and cognitive functions in the offspring. However, it has not yet been established whether the availability of sufficient iron is particularly important in certain phases during brain development, and whether possible damages are reversible if iron supplementation is provided during pregnancy. Here we report results from a pilot study in an experimental rat model suitable for introducing iron deficiency in the fetal rat brain.MethodsThe model was utilized for examination of the potential to reverse changes in fetal brain iron by maternal parenteral iron administration. Fertilized females subjected to iron deficiency without anemia were subcutaneously injected with iron isomaltoside at the day of mating (E0), 14 days into pregnancy (E14), or at the day of birth (Postnatal (P) 0). Blood, brain and liver in the offspring were examined on P0 or in adulthood on postnatal day P70.ResultsMaternal iron restriction during pregnancy led to significantly lower levels of iron in the brains of newborn rats compared to levels in pups of iron sufficient mothers. Females fed ID diet (5.2 mg/kg Fe) had offspring with significantly lower cerebral iron compared to a control group fed a standard diet (158 mg/kg Fe). Injection of IIM to pregnant ID females on E0 or E14 yielded normalization of Fe in the developing brain known to express elevated levels of capillary transferrin receptors, indicating that the administered iron passed the placenta and fetal blood brain barrier.ConclusionsIn future studies, this translational model may be applied to examine morphological and biochemical consequences of iron deficiency and iron deficiency treatment in the developing fetal brain.

Towards Holistic Heart Failure Management-How to Tackle the Iron Deficiency Epidemic?

Heart failure (HF) is a common, costly, disabling, and deadly clinical syndrome and often associated with one or several co-morbidities complicating its treatment or worsening its symptoms. During the last decade, iron deficiency (ID) got recognized as a frequent, debilitating yet easily treatable co-morbidity in HF. In this review, we focus on new evidence that emerged during the last 5years and discuss the epidemiology, the causes, and the clinical consequences of ID in HF. Apart from replenishing iron stores, intravenous iron improves patients' symptoms, perceived quality of life (QoL), exercise capacity, and hospitalization rates. These beneficial effects cannot be attributed to oral iron, as increased hepcidin levels, typical in inflammatory states such as HF, preclude resorption of iron from the gut. Intravenous iron is the only valid treatment option for ID in HF. However, there are several burning research questions and gaps in evidence remaining in this research field.

Fer et neurodéveloppement

In the central nervous system, iron is a cofactor of many metabolic processes and synthesis of aminergic neurotransmitters. Iron plays an major function on brain development from the prenatal period to teenage years. The blood-brain barrier modulates concentration of iron in the brain. In case of iron deficiency in the child, the negative impact on the myelinogenesis and synaptogenesis are well proven, with negative effects on psychomotor and cognitive functions. Iron supplementation has a beneficial effect, even if there is no anemia. The consequences of iron deficiency are more harmful as deficiency is early. The main mechanisms involved about iron and brain are reviewed.

Iron deficiency anemia in children younger than 1 year:the search for the formula of success of outpatient management of patients

172 newly diagnosed cases of iron deficiency anemia (IDA) in children younger than 1 year who were hospitalized in the Department of Hematology Saint Petersburg Сhildren Hospital No 1 in St Petersburg 2010-2015 were analyzed. Anamnesis peculiarities of IDA and outpatient care of babies, including individual prevention of iron deficiency and ferrotherapy and the causes of identified deviations from the existing patient management recommendations were clarified. Defects of sideropenia prevention found in all examined children. The fundamental error of pediatricians during ferrotherapy were the lack of verification of the nature of anemia, violation of drug dosing iron, lack of monitoring the effectiveness of treatment, failure to comply with the required duration of the courses of therapy. Mistakes made by pediatricians during the prevention, diagnosis and treatment of iron deficiency anemia are primarily a reflection of the deficit of basic knowledge of doctors on this issue. The effectiveness of the prevention of iron deficiency in infants is largely determined by the individual outpatient pediatrician, the level of his training, psychological stability and ability to engage constructively with the parents of patients. Components of success of outpatient management of patients younger than 1 year with iron deficiency are: the presence of a modern background knowledge on the issue, understanding the health and social consequences of iron deficiency for the younger generation and the desire to make a personal contribution to improving the health of children in Russia.

Muscle specific iron deficiency has systemic consequences

Muscle specific iron deficiency has systemic consequences

Iron: Current Landscape and Efforts to Address a Complex Issue in a Complex World

N utritional iron deficiency is the leading nutrient deficiency worldwide affecting more than 1 billion people, predominantly women, infants, and young children. The consequences of iron deficiency are significant for shortand longterm health, economic growth, and development. The question of how to best identify those at risk, as well as how to monitor the success of interventions in patients and populations, is complicated by a number of factors that include a complex biology and homeostatic controls that can compromise the safety and efficacy of interventions to address this global scourge. The complexity of this situation is exemplified by the reciprocal relationships between iron and the inflammatory response under a variety of developmental and health conditions. Not only does iron play an integral role in the function of the immune system and key elements of the inflammatory response, the converse is also true. This complex interrelationship is graphically manifested in the area of iron assessment as the performance and interpretation of the most common biomarkers used for iron assessment are affected by the presence of inflammation. Inflammation can be acute (because of infection) or chronic (because of obesity or a myriad of noncommunicable diseases). In effect, the inflammatory response causes the body to mobilize iron out of the peripheral circulation and reduces its ability to absorb iron from the diet. This physiological response then causes changes in the concentrations of biomarkers that reflect changes in iron physiology rather than changes in nutrition. Thus, one might interpret such results as reflecting a nutritional “deficiency” that is in fact a response to an infection and inflammation rather than a decrease in iron consumption. The dilemma this presents is that if someone actually is not nutritionally deficient and receives iron, it may not be safe. The details of this challenge, clinically and programmatically, are the focus of a series of activities that will be summarized.

Young donor health and safety: are we doing enough?

In some countries, blood collection is permitted from donors as young as 16 years of age. Young donors represent a unique challenge for blood collection organizations as they must balance their need for these donors against protecting the health and safety of this potentially vulnerable donor population. As young donors have become increasingly important to ensuring the adequacy of the blood supply, donor haemovigilance programmes found that they were disproportionally affected by adverse blood donation reactions. These findings served as the impetus for many blood collection organizations to implement interventions to reduce donor reaction rates in the younger age groups. While blood collectors have made great strides in reducing the rates of immediate adverse reactions of blood donation, less attention has been paid to possible long‐term consequences of iron deficiency. With increased reliance on young donors to provide a significant part of the blood supply, it is of the utmost importance that these donors have a good experience when they donate blood and do not suffer any adverse health and safety effects from their altruistic act. Adverse donor reactions and iron deficiency still pose threats to the health and safety of young donors. Continued research is needed in both of these areas to adequately protect young donors.

Transcriptional regulation of copper metabolism genes in the liver of fetal and neonatal control and iron-deficient rats.

Copper and iron metabolism have been known to interact for many years. We have previously shown, during pregnancy, that copper levels in the maternal liver rise as a consequence of iron deficiency, but that levels in the fetal liver decrease. In this paper, we measure expression of genes involved in copper metabolism in fetal and postnatal liver, to test whether alterations can explain this observation. Additionally, we study the extent to which gene expression changes in the latter stages of pregnancy and in the perinatal period. Ctr1 expression levels dropped to term, rising again thereafter. There was no difference in gene expression between control and iron deficient animals. Atox1 expression remained approximately stable until term, and then there was a rise to a maximum at about Day 8. Atp7a expression levels remained constant, except for a brief drop at term. Atp7b levels, in contrast, decreased from a maximum early in gestation to low levels in the term and post-natal livers. Ceruloplasmin expression appeared to be diametrically opposite to Atp7b. The other two metallochaperones showed the same pattern of expression as Atox1, with a decrease to term, a rise at Day 1, or a rise after birth followed by a brief decrease at about Day 3. None of the genes were significantly affected by iron deficiency, suggesting that changes in expression cannot explain the altered copper levels in the fetal and neonatal liver.

Identification, prevention and treatment of iron deficiency during the first 1000 days.

Iron deficiency is a global problem across the life course, but infants and their mothers are especially vulnerable to both the development and the consequences of iron deficiency. Maternal iron deficiency during pregnancy can predispose offspring to the development of iron deficiency during infancy, with potentially lifelong sequelae. This review explores iron status throughout these “first 1000 days” from pregnancy through two years of age, covering the role of iron and the epidemiology of iron deficiency, as well as its consequences, identification, interventions and remaining research gaps.