Abstract 1523
Poster Session III, Monday, 5/3 (poster 38)
Little is known about the iron deficiency to term and ELBW infants include anaemia and possible effects on life but risks of iron deficiency to term and ELBW infants include anaemia and possible effects on psychomotor development. We studied haemoglobin (Hb), mean cell volume (MCV), red cell (RBC) and reticulocyte counts and ferritin at 4 and 8 months corrected age in a group of ELBW infants compared too term born controls at 4 and 8 months. The study group (n=28) had median (range) birthweight 770(515-1095)grams and gestational age 26(24-32) weeks and had received 4(0-12) red cell transfusions in the newborn period. The controls (n=24) were born between 38.3 and 41.5 weeks with a median birthweight of 3650 grams. Since the purpose of the study was to describe the results of current post-discharge management no attempt was made to influence iron intake, this being determined by the parents and their normal caregivers. At 4 months, 36% of the ELBW group were receiving oral iron supplements compared to none of the controls, 64% of the ELBW group received iron fortified formula compared to 42% of the controls, and 40% of both groups were receiving iron containing solid feelings. At 8 months, 33% of the ELBW group were still receiving oral iron compared to none of the controls, 71% of the ELBW group were receiving iron fortified formula compared to 45% of the controls, and all were receiving iron containing solids. At 4 months there was no difference between ELBW and control groups in Hb (119 vs 117), MCV (78 vs 80), RBC (4.4 vs 4.3) reticulocyte count (95 vs 82), or ferritin (11.5 vs 19.5). 50% of ELBW children and 30% of controls had ferritin <12 mcg/l. At 8 months the ELBW group had significantly higher Hb (125 vs 116, p<0.001, 95%CI -12.8 to -3.9), RBC (4.74 vs 4.46, p<0.01, 95%CI -0.48 to -0.07) and reticulocyte count (99 vs 78, p,0.05, 95%CI -46.9 to -1.0). There was no difference in proportion with ferritin <12 mcg/l between groups (62% vs 60%). In both groups there was no difference in mean Hb level between babies with ferritins <12 and those ≥12. In this study ELBW infants with a higher level of iron supplementation achieved higher Hb, RBC and reticulocyte counts at 8 months than term born controls. Despite that, a low ferritin level, suggesting low iron stores, was present in more than half of each group. These results support the need for iron supplementation in ELBW infants in the first year of life and confirm the significant incidence of low iron stores in term born babies at 8 - 9 months.
