Hemoglobin In Infants Research Articles

Maternal Anemia during Pregnancy and Infant Birth Outcomes: A Prospective Cohort Study in Eastern Maharashtra, India

BackgroundAnemia during pregnancy may be associated with poor infant outcomes, although its consequences may vary based on etiology and timing. ObjectivesWe examined the associations between anemia and anemia-related biomarkers during pregnancy and infant outcomes [birthweight, gestational age at birth, birthweight-for-gestational age percentile, and infant hemoglobin (Hb) at 6 wk of age] in Nagpur, Eastern Maharashtra, India. MethodsWe conducted a prospective cohort study of 200 pregnant women. In the first trimester, venous blood was collected to assess Hb via cyanmethemoglobin analysis, micronutrient status (ferritin, vitamin B12, and folate), and inflammation (C-reactive protein). Hb was also assessed in capillary samples using a hemoglobinometer in the first and third trimesters for mothers and at 6 wk for infants. Associations were assessed using generalized linear models controlling for background characteristics. ResultsIn the first trimester, high (compared with normal) venous Hb was significantly associated with lower gestational age at birth [β: −1.0 wk, 95% confidence interval (CI): −1.9, −0.2] and higher birthweight-for-gestational age percentile (β: 20.1, 95% CI: 9.0, 31.2). Mild anemia, moderate anemia, and high (compared with normal) capillary Hb were significantly associated with lower birthweight (β: −147.7 g, 95% CI: −243.4, −51.7; β: −77.7 g, 95% CI: −123.9, −31.4; and β: −236.0 g, 95% CI: −478.0, −48.1) and birthweight-for-gestational age percentile (β: −7.3, 95% CI: −13.7, −0.9; β: −8.4, 95% CI: −14.1, −2.8; and β: −8.9, 95% CI: −15.9, −1.9). Higher serum ferritin was significantly associated with higher birthweight (β: 2.0 g, 95% CI: 0.1, 3.9) and gestational age at birth (β: 0.01 wk, 95% CI: 0.00, 0.01). In the third trimester, mild anemia was significantly associated with lower gestational age at birth (β: −0.5 wk, 95% CI: −0.7, −0.3). ConclusionsAssociations between maternal anemia during pregnancy and infant outcomes were mixed indicating further studies are needed to better understand these relationships.

Developmental changes in neonatal hemodynamics during tactile stimulation using whole-head functional near-infrared spectroscopy

Neural-activity-associated hemodynamic changes have been used to noninvasively measure brain function in the early developmental stages. However, the temporal changes in their hemodynamics are not always consistent with adults. Studies have not evaluated developmental changes for a long period using the same stimuli; therefore, this study examined the normalized relative changes in oxygenated hemoglobin (Δ[oxy-Hb]) in full-term infants and compared them with neonates up to 10 months of age during the administration of tactile vibration stimuli to their limbs using whole-head functional near-infrared spectroscopy. The time to peak of normalized Δ[oxy-Hb] was not affected by age. The amplitude of normalized Δ[oxy-Hb] showed an effect of age in broader areas, including sensorimotor-related but excluding supplementary motor area; the amplitude of normalized Δ[oxy-Hb] decreased the most in the 1–2-month-old group and later increased with development. We hypothesized that these results may reflect developmental changes in neural activity, vasculature, and blood oxygenation.

Maternal prenatal, with or without postpartum, vitamin D3 supplementation does not improve maternal iron status at delivery or infant iron status at 6 months of age: secondary analysis of a randomised controlled trial

BackgroundVitamin D may modify iron status through regulation of hepcidin and inflammatory pathways. This study aimed to investigate effects of maternal vitamin D supplementation on iron status in pregnancy and...

Effect of delayed cord clamping on cerebral hemodynamics in preterm infants

BackgroundUnstable cerebral hemodynamics is an important cause of intracranial hemorrhage in premature infants. The increased blood flow of delayed cord clamping (DCC) compared to immediate cord clamping (ICC) is equivalent to 1/3-1/4 of newborn blood volume. Our objective was to assess whether the increased blood flow causes fluctuations in cerebral blood flow and how. MethodsThis experiment was a prospective, observational study. Neonatologists selected preterm infants eligible for inclusion and exclusion, and divided them into DCC group and ICC group according to the way of umbilical cord ligation performed by obstetrics department, and matched them 1:1 according to gestational age. The peak systolic velocity （PSV) ，end diastolic velocity (EDV)，and resistance index (RI) of middle cerebral artery was measured by Mindray M9 color ultrasonic diagnostic instrument within 1 h, 24±1 h, 48±1 h, 72±1 h, respectively. ResultsThere was no significant difference in PSV, EDV and RI in middle cerebral artery between DCC group and ICC group (P > 0.05). There were no significant differences between groups and time (P > 0.05). The hemoglobin and hematocrit in DCC group were higher than those in ICC group within 2 h after birth (P < 0.05). (P > 0.05). ConclusionDCC can increase hemoglobin and hematocrit in preterm infants, but does not cause cerebral blood flow fluctuation within a certain range. DCC is a safe method of placental transfusion.

Alterations in Placental Inflammation-Related Gene Expression Partially Mediate the Effects of Prenatal Alcohol Consumption on Maternal Iron Homeostasis.

Prenatal alcohol exposure (PAE) is associated with alterations in maternal and infant iron homeostasis that are consistent with changes seen in the setting of inflammation. We hypothesized that PAE leads to alterations in the placental expression of genes related to iron metabolism and inflammation that play functional roles in the teratogenic effects of alcohol on iron homeostasis. A total of 126 heavy-drinking women (≥1 oz (30 mL) absolute alcohol/day (~1.67 standard drinks/day) or women reporting binge drinking (≥2 drinks/occasion)) and 80 control women (<0.5 oz AA per day, no binging) in Cape Town, South Africa were interviewed prenatally regarding demographics, and alcohol, smoking, and drug use around conception and during pregnancy. Prenatal/maternal and infant hemoglobin and ferritin were measured. Whole-transcriptome RNA sequencing analysis was performed on flash-frozen transplacental tissue samples. Gene sets related to iron metabolism (n = 398) and inflammation (n = 467) were constructed by searching the Molecular Signatures Database for related ontology terms. Principal component analysis (PCA) yielded 59 factors for each theme. In multivariable regression models, PAE was related to 2 iron metabolism PCA factors (PCs) and 5 inflammation PCs, among which 2 iron metabolism and 4 inflammation factors were related to at least 1 key maternal or infant iron outcome. In causal inference analyses based on marginal structural models and the product method, the alterations in the expression profile of genes with functions in immune cell regulation, cytokine activity, angiogenesis, hematopoiesis, and ubiquitous cell processes appeared to partially mediate the relation of prenatal drinking frequency (days/week) around conception to a lower maternal hemoglobin-to-log(ferritin) ratio (proportion mediation = 51.35%). These findings suggest that placental inflammation may be partly responsible for the differences in alcohol-related iron homeostasis patterns between pregnant and non-pregnant adults.

Comparing delayed cord clamping and umbilical cord milking during elective cesarean section for the neonatal outcome.

to compare between immediate cord clamping, delayed cord clamping, and umbilical cord milking and their effects on hemoglobin and bilirubin level in term infants in cesarean section. A randomized clinical trial was conducted from November 2021 to June 2022, including 162 full term pregnant women undergoing elective cesarean section at EL-Shatby Maternity University Hospital. They were randomly assigned (1:1:1 ratio) either to immediate cord clamping just after delivery (Group 1) or delayed cord clamping for 30s (Group 2) or umbilical cord milking 10 times for 10-15s (Group 3). The primary outcome measures included hemoglobin and hematocrit levels of the newborn at birth and the secondary outcome was bilirubin level measurement at 72h of life. one hundred sixty- two newborns were randomized into 3 groups, fifty-four cases in each, and were investigated on hemoglobin and hematocrit levels; five were lost to follow-up and one hundred fifty-seven were tested for bilirubin. Participants among groups had no significant difference regarding demographic and clinical characteristics, regarding the hemoglobin at birth it was significant higher in the umbilical cord milking group (Group 3) through all groups (14.91±0.91g/dl vs15.38±0.74g/dl vs 16.56±1.03g/dl, p value <0.001), regarding hematocrit level at birth it was significant in the umbilical cord milking group (Group 3) through all groups (44.71±2.94 vs 46.48±2.61 vs 49.74±3.26, p value <0.001). On the other hand, bilirubin level after 72h had no significant different through the 3 groups (8.80(IQR 4.50-17.20), vs 9.70(IQR3.50-14.70), vs 8.50(IQR 3.20-19.50), respectively p value=0.348). this study showed that umbilical cord milking 10 times for 10-15s is more effective than delayed cord clamping for 30s in enhancing hemoglobin and hematocrit levels in newborn delivered by cesarean section with no significant difference on bilirubin level in the newborn.

Hemolytic disease of the newborn due to anti-Jra from a Chinese mother with one novel and one classic heterozygous mutation.

Investigation of a Jr(a-) family samples, identification of the mutant and assessment of the differences of Jr antigen density of the Jr(a-) family members, random adult and newborn individuals' RBCs. The anti-Jra antibody is generated when a Jr(a-) individual pregnant or transfused with Jr(a+) blood unit, which can lead to mild-to-moderate hemolytic disease of the foetus and newborn (HDFN) or hemolytic transfusion reaction (HTR). Several mutations had been identified. The anti-Jra caused HDFN is not rare in East Asia, but due to the lack of antibody and molecular background, it is likely to lead missed detection. One G4P1 woman had been detected as IAT positive during prenatal examination. Suspected as anti-Jra after the laboratory serological testing, the maternal sample was further assessed by molecular analysis. The antigen density was detected by flow cytometry after reacting with anti-Jra serum in family members and the normal individuals. One novel frameshift mutation c.717delC and one previously identified mutation c.706C > T in ABCG2 was identified on proband. The infant haemoglobin(Hb) and bilirubin increased significantly after exchange transfusion and the severe HDFN was relieved. Flow cytometry results showed that the Jra antigens on adult RBCs were significantly less than those on the infant. The c.717delC mutation can lead to the shortening of protein ABCG2 in the site of p.Leu307Stop, result in the loss of Jra antigen. The difference in antigen density between adult and infant RBCs may be a possible reason that leads to severe HDFN but not transfusion reaction. Breastfeeding may lead to slower recovery from HDFN.

Correlation of glycosylated hemoglobin and macrosomia in infants of diabetic mothers

Objective: Maternal diabetes mellitus has a significant impact on the neonatal outcome. Birth weight is related to the degree of glycemic control. Poor glycemic control in the mother causes somatic overgrowth and results in macrosomia. Maternal obesity is an independent risk factor for macrosomia. The study objective was to evaluate the correlation between glycosylated hemoglobin (HbA1c) level in diabetic mothers and macrosomia in their neonates. Methods: A cross-sectional observational study was done on diabetic mothers and their neonates. Maternal body mass index, weight gain, duration of diabetes and type of treatment were recorded. Maternal HbA1c levels were measured within one hour of delivery and birth order, mode of delivery, gestational age and birth weight were recorded. The discrete variables were analyzed by chi-square test and continuous variables by independent t-test. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off for predicting macrosomia with HbA1c. A p-value of &lt;0.05 was considered significant. Results: A total of 228 diabetic mothers and their neonates were studied and 18 neonates were macrosomic. Diabetes was pregestational in 56.6% of mothers and gestational in 43.4% of mothers. There was a significant difference in BMI, weight gain, and HbA1c in mothers of macrosomic and non-macrosomic neonates. There was no significant difference in mean values of maternal age, duration of diabetes and gestational age in the two groups. Conclusion: This study suggests that diabetic women with elevated HbA1c&gt;5.6% measured after delivery were likely to have macrosomic neonates.

Long-Awaited AAP Hyperbilirubinemia Guidelines Have Arrived.

Long-Awaited AAP Hyperbilirubinemia Guidelines Have Arrived.

Hemoglobin ratio as a forgotten parameter for automatic feedback control systems in preterm neonates

Abstract This paper deals with the analysis of the relationship between fetal hemoglobin (HbF) and adult hemoglobin (HbA) in preterm infants as a function of the gestational week and newborn weight based on the available literature. The role of other parameters on the shift and shape of the OHDC curve is also discussed. The function could be useful when dynamic development of OHDC in a neonate occurs in emergencies such as blood transfusions. The main idea is to incorporate the dynamic evolution of the hemoglobin conversion as a mathematical function into existing models of oxygenation in preterm neonates or into automatic feedback control algorithms of oxygenation. This could help further individualize and optimize the oxygenation settings of preterm neonates.

Iron status of exclusively breastfed low-birth-weight infants born to anemic mothers and effect of maternal iron supplementation for 3 versus 6 months: A randomized double-blind placebo control trial.

BackgroundThe effect of maternal iron supplementation during lactation on the iron status of exclusively breastfed low-birth-weight (LBW) infants is not known.Objective(1) To find out the number of LBW exclusively breastfed infants having hemoglobin < 10.5 g/dL at 6 months when mothers received iron. (2) To find out the proportion of anemic infants when mothers received iron for 3 and 6 months.DesignThe Clinical Trials Registry, India (CTRI) registered trial (CTRI/2018/08/015516) double-blind randomized control trial participants: A total of 80 anemic mothers and exclusively breastfed LBW infants.InterventionA total of 80 anemic mothers and exclusively breastfed infants, birth weight 1,500–2,499 g, randomized into two groups of 40 each. Mothers received daily iron for 3 months and placebo for the next 3 months in group A and iron for 6 months in group B. Iron profile of mothers and infants measured at recruitment and 6 months.ResultsIn total, 26.6% infants developed anemia till 6 months of age, and number of anemic infants were similar whether mothers received iron for 3 (n = 9) or 6 months (n = 11). Hemoglobin (12.89 + 0.46 vs. 12.44 + 0.48 g/dL; p < 0.001) and serum ferritin (27.45 + 7.60 vs. 18.94 + 5.36 ng/mL; p < 0.001) were significantly higher in infants at 6 months of age whose mothers received iron for 6 months in comparison to 3 months. Conclusion: totally, 26.6% exclusively breastfed infants developed anemia till 6 months of age when mothers took iron; number of anemic infants were not different if mothers received iron for 3 or 6 months. A significant increase was noted in serum ferritin with slightly higher hemoglobin of infants when mothers received iron for longer duration.Clinical trial registration[http://ctri.nic.in/Clinicaltrials/pubview.php], identifier [CTRI/2018/08/015516].

Iron Supplementation Is Associated with Improvement of Motor Development, Hemoglobin Level, and Weight in Preterm Infants during the First Year of Life in China.

Iron supplementation is recommended for preterm infants due to impaired iron endowment. However, the health outcomes of this recommendation remain controversial. Thus, this study aimed to determine the association of iron supplementation with neurobehavioral development, hemoglobin (Hb), and anthropometric characteristics in preterm infants. A retrospective cohort design was applied to collect data from 1568 preterm infants at 0–3 months of corrected age (mo CA) from a hospital in South China. Infants were categorized into a 3-month iron supplementation group (IG, n = 697) or a control group (CG, n = 871) according to medical records, and then followed through to 12 mo CA. Data on neurobehavioral development, anthropometry, Hb level, history of diseases, and nutrition were collected at 3, 6, and 12 mo CA. The results showed that, compared with the CG, iron supplementation was positively related to improved gross motor skills and weight at 6 mo CA (β = 1.894, β = 5.322) and 12 mo CA (β = 4.019, β = 6.830) and fine motor skills at 12 mo CA (β = 1.980), after adjustment for confounding factors including illness, nutritional supplements, and diet. Iron supplementation was also related to elevated Hb levels and its increase at 3 mo CA (β = 2.196, β = 3.920) and 6 mo CA (β = 3.011, β = 7.259). In conclusion, iron supplementation for 3 months in Chinese preterm infants is positively associated with improved motor development, elevated Hb levels, and higher body weight during the first year of life.

Nutrient-Dense Moringa oleifera Leaf Supplementation Increases Human Milk Output in Western Kenyan Mothers

ObjectivesWe aim to evaluate the impact of moringa leaf powder on maternal and infant nutrition, milk output, and intestinal health.MethodsThis was a single-blinded cluster-randomized controlled trial of 20g of moringa in corn porridge versus porridge alone taken daily for 3 months by exclusively breastfeeding women of term infants (>36 weeks gestational age) enrolled within 30 days of birth in Kisumu, Kenya. At enrollment and exit, we collected 24-hour pumped milk output, milk, maternal and infant fecal and capillary samples, and Hemoglobin by HemoCue©. We performed monthly infant and maternal anthropometrics. We will perform biosample analysis for markers of vitamin A and iron status, IGF-1, and inflammatory markers; milk/fecal microbiome; milk composition; and intestinal inflammation/markers of environmental enteric dysfunction. Data is analyzed via IBM SPSS v.27 with univariate and multivariate analysis for primary and secondary outcomes.ResultsN = 50 mother-infant pairs (infants 44% female). Most infants were appropriate for gestational age (GA) (27, 54%) with 19 (38%) large for GA and 1 small for GA. Mothers’ were initially 14% wasted (MUAC < 23cm), with MUAC 26.2 ± 2.7cm overall, n = 49. Wasting resolved in all. Maternal 24-hour milk output did not differ at enrollment between clusters (502.5,303.8–896.3, n = 24 vs. 525.0,363.8–693.8 mL, n = 24; p = 1.0) but did increase dramatically at exit in the cluster receiving moringa (control: 648.81 ± 324.1, n = 21 vs. intervention: 981.09 ± 368.3 mL, n = 23; p = 0.003). Infant growth (average daily weight gain, total weight gain, WLZ, WAZ, or LAZ) and maternal MUAC and BMI did not differ between clusters at enrollment or exit. Maternal and infant hemoglobin (hgb) did not differ between clusters at enrollment; maternal anemia (hgb < 11 g/dL) trended higher in the control at enrollment (40% vs. 12.5%, n = 49, p = 0.05); at exit this difference resolved. Infant hgb was higher at exit in the intervention group (11.3 ± 0.8 vs. 10.7 ± 1.0, p = 0.02). No participants experienced adverse effects.Conclusions20g daily moringa leaf powder for three months increases maternal milk output but has no impact on growth in a sample of Kenyan infants and mothers with a low rate of initial undernutrition.Funding SourcesThis research was funded by an NIH K award and an NIH BIRCWH Award as well as early investigator startup funds from the University of Kentucky.

Association between umbilical cord clamping time, hemoglobin and total serum bilirubin in term neonates admitted for phototherapy

BackgroundThe aim of the study was to investigate relationship between cord clamping status, total hemoglobin (THb) and total bilirubin (TBil) in term infants requiring phototherapy for neonatal jaundice. MethodsThis retrospective study included term infants admitted at the study hospital for management of physiological neonatal jaundice between 2013 and 2019. Associations between THb, TBil, cord clamping status and Direct Coombs Test (DCT) status, as well as correlation between laboratory and blood gas analyzer (BGA) methods were investigated. Results258 term infants were included. 147 infants had cord clamping status documented; 111 had unknown cord clamping status. Delayed cord clamping (DCC) was associated with significantly higher mean THb in DCT negative infants only. Negative DCT was associated with higher THb and TBil regardless of cord clamping status. Mean TBil concentration did not change with increasing THb or cord clamping status. The incidence of term infants admitted for phototherapy increased over the study period. There was strong positive correlation between BGA and laboratory assays. ConclusionsDCC was associated with a higher THb in DCT negative infants only. There was no correlation between THb and TBil. There was strong positive correlation of TBil between BGA and laboratory assays thus supporting BGA use in ambulatory care settings.

Time-Varying Associations between Food Insecurity and Infant and Maternal Health Outcomes

BackgroundFood insecurity (FI) is dynamic for families and adversely affects infant and maternal health. However, few studies have examined the longitudinal impact of FI on infant and maternal health. ObjectivesWe aimed to examine the relation between food insecurity in the first year of life and infant and maternal health outcomes. We hypothesized FI would be associated with poorer infant and maternal health outcomes. MethodsWe conducted a retrospective cohort study of 364 infants 12–15 months and their caregivers receiving care at a single primary care clinic. The exposure of interest was food insecurity measured during well-child checks using a validated 2-item screening tool. The primary outcome was infant weight-for-length z score. Secondary outcomes included infant log-transformed ferritin, infant hemoglobin, infant lead concentrations, and maternal depression, assessed by the Edinburgh Postnatal Depression Scale. Unadjusted and adjusted effects were estimated using generalized mixed linear models, and the linear effect of visit time was tested using likelihood ratios. ResultsIn adjusted models, no overall association between FI and infant weight-for-length z score was observed; however, FI male infants had lower weight-for-length z scores than female infants (P = 0.05). FI infants had 14% lower log ferritin concentrations per month of exposure to FI. FI was positively associated with maternal depression (IRR 5.01 [95% CI 2.21–11.3]). ConclusionsFood insecurity can have longitudinal and demographically-varied associations with infant and maternal outcomes that warrant further exploration.

Family Characteristics and Anemia in Relation to Preference and Food Variety in Infant Complementary Food

After exclusive breastfeeding periods (6 months), complementary food becomes critical for infant health. To identify the preference and food variety in homemade complementary food, and correlate it with family characteristics and anemia in infant, we conducted a cross-sectional studies. Participants were 51 pairs of infants (6-10 months old) and their mothers in Magelang regency, Central Java, Indonesia. Questionnaires on family characteristics and complimentary food were used. Infant Haemoglobin (Hb) levels measured. This study showed, most mothers selected homemade (64.7%). Almost all infant had anemia (93.9%) and low variation in homemade complementary food (87.9%). The food ingredients used were dominated by rice (72.7%) and vegetables (84.8%). Tubers (3%), nuts (3%), and animal protein sources (15.5%) were least selected. Parental characteristics were not related to the instant or homemade preference (p> 0.05). Higher maternal age (r=0.38; p<0.05) and more food ingredients in homemade complementary food (r=0.92; p<0.05) related to higher Hb level. Since more food ingredients related to lower risk of anemia, enhancing complementary food variation in 6-12 months infant is urgently required. Education for families to assure nutritional sufficiency on 6-12 months infant complementary foods should be easy to access and relevant to the availability of local food ingredients

Telehealth education improves parental care ability and postoperative nutritional status of infants after CHD surgery: A prospective randomized controlled study.

This study aimed to explore the effect of telehealth education on improving the parental care ability and postoperative nutritional status of infants after congenital heart disease surgery. A prospective randomized controlled study was conducted at a provincial maternal and child hospital in southeastern China. A total of 84 infants were enrolled in the study, with 42 infants in the intervention group and 42 infants in the control group. Body weight, albumin, prealbumin, and hemoglobin of infants in the intervention group were significantly higher than those in the control group one month after discharge (P<0.05). The STRONGkids score of infants in the intervention group was significantly higher than that of those in the control group one month after discharge (P<0.05). The Family Caregiver Task Inventory score of infants in the intervention group was significantly lower than that of those in the control group one month after discharge (P<0.05). Performing telehealth education about home feeding and care guidance for parents of infants after congenital heart disease surgery can greatly improve parental care ability so that infants get better feeding and care, which can effectively improve the postoperative nutritional status of the infants.

Safety and efficacy of Hemocare®LACT on breast milk production and prolactin levels in postpartum mothers: An open-label, placebo controlled, randomized trial

BackgroundBreast-feeding provides optimal nutrition along with immune support to newborns and infants and a host of lifelong health benefits to mother and child. Unfortunately, in daily health care practice, there are increasing numbers of reports on unsuccessful breastfeeding related problems. Galactagogues are substances that stimulate milk production. Hemocare®LACT, is a product of MMC Pharmaceuticals Ltd to enhance the milk secretion in lactating women. ObjectiveTo evaluate the safety and efficacy of Hemocare®LACT capsules on prolactin levels, infant body weight and hemoglobin in lactating mothers. MethodsOpen-label, placebo controlled, pilot, randomized controlled trial was conducted in a tertiary care hospital. A total of 72 eligible mothers were randomized to placebo or Hemocare®LACT in the ratio of 1:1. Serum prolactin, hemoglobin levels and infant weight were evaluated at baseline, 30th day, 60th day and in the 90th day post commencement of treatment. ResultsA significant difference in infant weight was found from baseline to 90th day in Hemocare®LACT group (p<0.01). Similarly, statistically significant difference was found in prolactin levels at 90th day when compared to baseline (p<0.05). Hemoglobin levels well maintained in Hemocare®LACT group. ConclusionHemocare®LACT capsules increased prolactin levels and infants body weight in lactating mothers when compared to placebo with good tolerability.

Prenatal alcohol-related alterations in maternal, placental, neonatal, and infant iron homeostasis

Prenatal alcohol exposure (PAE) is associated with postnatal iron deficiency (ID), which has been shown to exacerbate deficits in growth, cognition, and behavior seen in fetal alcohol spectrum disorders. However, the mechanisms underlying PAE-related ID remain unknown. We aimed to examine biochemical measures of iron homeostasis in the mother, placenta, neonate, and 6.5-month-old infant. In a prenatally recruited, prospective longitudinal birth cohort in South Africa, 206 gravidas (126 heavy drinkers and 80 controls) were interviewed regarding alcohol, cigarette, and drug use and diet at 3 prenatal visits. Hemoglobin, ferritin, and soluble transferrin receptor (sTfR) were assayed twice during pregnancy and urinary hepcidin:creatinine was assayed once. Infant ferritin and hemoglobin were measured at 2 weeks and 6.5 months and sTfR was measured at 6.5 months. Histopathological examinations were conducted on 125 placentas and iron transport assays (iron regulatory protein-2, transferrin receptor-1, divalent metal transporter-1, ferroportin-1, and iron concentrations) were conducted on 63. In multivariable regression models, prenatal drinking frequency (days/week) was related to higher maternal hepcidin and to sequestration of iron into storage at the expense of erythropoiesis in mothers and neonates, as evidenced by a lower hemoglobin (g/dL)-to-log(ferritin) (ug/L) ratio [mothers: raw regression coefficient (β) = -0.21 (95% CI: -0.35 to -0.07); neonates: β = -0.15 (95% CI: -0.24 to -0.06)]. Drinking frequency was also related to decreased placental ferroportin-1:transferrin receptor-1 (β = -0.57 for logged values; 95% CI: -1.03 to -0.10), indicating iron-restricted placental iron transport. At 6.5 months, drinking frequency was associated with lower hemoglobin (β = -0.18; 95% CI: -0.33 to -0.02), and increased prevalences of ID (β = 0.09; 95% CI: 0.02-0.17) and ID anemia (IDA) (β = 0.13; 95% CI: 0.04-0.23). In causal inference analyses, the PAE-related increase in IDA was partially mediated by decreased neonatal hemoglobin:log(ferritin), and the decrease in neonatal hemoglobin:log(ferritin) was partially mediated by decreased maternal hemoglobin:log(ferritin). In this study, greater PAE was associated with an unfavorable profile of maternal-fetal iron homeostasis, which may play mechanistic roles in PAE-related ID later in infancy.

Anthropometric outcome in low birth weight infants treated with erythropoietin; a randomized clinical trial

Introduction: Erythropoietin (EPO) is a glycoprotein hormone, which has a key role in the number of red blood cells in mammalian blood. Objectives: The aim of this study was to evaluate whether EPO is associated with anthropometric outcomes in low birth weight infants. Patients and Methods: This study was conducted on 90 premature neonates aged under 35 gestational weeks, with the weight of less than 2000 g, and selected through convenience sampling. The subjects were assigned to EPO (n=45) and control groups (n=45) by random allocation with the aim of evaluating the relationship between EPO and anthropometric outcome, hemoglobin, and hematocrit in low birth weight infants. The weight and head circumstance of the infants were measured on their birthdays, and days 14, 28, and 42. Additionally, hemoglobin and hematocrit were measured on days 7 and 42. From day 14, EPO injection was given to the EPO group three times a week for one month (12 times). The dosage for each baby was 100 U/kg of 2000 unit ampules which was given as a subcutaneous injection in the baby’s arm. Results: The mean weights on birthday and day 42 in the EPO group were 1397±270 g and 2614±739 g, respectively, while in the placebo group they were 1280±281 g and 1486±208 g, respectively. In addition, the mean head circumstance on birthday and day 42 in the EPO group was 28.6±1.7 cm and 33±2.5 cm, respectively, while in the placebo group it was 27.8±2.3 cm and 29.8±2.2 cm, respectively. Conclusion: According to the results of the current study, weight gain and head circumstance gain rose significantly in the EPO group compared with the placebo group (P&lt;0.001). Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials website (identifier: IRCT20160511027853N2, https://en.irct.ir/trial/47069, ethical code; IR.QUMS.REC.1398.133).