Prematurity anemia: effect of iron supplementation

The study was designed to assess the effect of prophylactic iron administration on the occurrence of early and late prematurity anemia and on iron deposits in an attempt to determine the recommendable time for the initiation of enteral supplementation and the effectiveness of the dose used (2 mg/kg/day). We used 25 preterm newborns with 30 to 35 weeks of gestational age and birth weight of 1000 to 1800 g. The infants were divided into two groups according to the beginning of supplementation: Group I at 15 days of life, and Group II at 2 months. Weight, length, skull circumference and levels of hemoglobin, hematocrit, reticulocytes, ferritin, serum iron, vitamin E/total lipid ratio and globular resistance to hydrogen peroxide were determined for each infant at 0-5 days and at 2 months +/- 15 days, 6 months +/- 15 days, 9-10 and 12 months +/- 15 days. The groups did not differ (p>0.05) in terms of the various parameters studied, except for higher ferritin levels and lower vitamin E levels in Group I at 2 months of age. The alternative of offering iron to these children at 15 days of life is justified because no higher incidence or greater severity of early prematurity anemia was detected, and because, at 2 months of age, infants who had not been supplemented were already showing depleted iron stores. The prophylactic dose of 2 mg/kg/day administered by the enteral route, even when started at 15 days of age, was not sufficient to prevent late anemia in a significant contingent of these infants. (C) 2001 Elsevier Science Inc. All rights reserved.