Haemoglobin and iron store status in low birth weight babies and effect of early iron supplementation on them A randomized and open label study

Abstract

Deficiency of iron affects multiple organ systems, and poor neurodevelopment is the most worrisome effect. Low birth weight neonates are more likely to develop iron deficiency anemia than term counterparts. The guidelines for supplementation of iron in LBW neonates are poorly defined with varying recommendations pertaining to the intiation. Hence this study focuses on the effect of early iron supplementation and iron store status in them.In this randomized open label interventional study, 48 LBW neonates (EI group) were administered iron supplementation (at 2 weeks or earlier when full feeds were achieved), and other 48 were controls. All neonates were assessed for hemoglobin level, RBC count and iron status indicators (Hematocrit, Serum Ferritin) at or after 6 weeks of postnatal age. The post-intervention values of mean haemoglobin (cases 12.68±1.51g/dl, Controls – 11.38 ± 1.03g/dl), mean serum ferritin (cases: 238.45 ng/ml, CONTROLS- 175.68 ng/ml), mean RBC count (cases: 3.94 million/mm, and mean hematocrit (cases: 33.16±3.75%, controls 34.04±3.45%)were noted, and the % change at 6 weeks follow up in mean Hb among - 25.19%, 31.45% (0.01); % change in mean ferritin at follow up: cases 15.13%, controls 32.99% (0.001); % change in mean RBC count at follow up: cases 19.21%, 33.82% (0.001)] when compared to pre- inetervention values was noted. Though the haematological parameters decreased in both groups, the levels were comparatively higher in the cases compared to the controls, and iron store status was better in early iron-supplemented infants. Iron supplementation in LBW neonates started as early as 2 weeks postnataly, improves the iron stores and decreases the risk of iron deficiency in these infants.