Iron supplements reduce the risk of iron deficiency anemia in marginally low birth weight infants

Pediatrics. 2010 Oct;126(4):e874-83. doi: 10.1542/peds.2009-3624. Epub 2010 Sep 6.

Abstract

Objective: Low birth weight infants are at risk for iron deficiency (ID). Most LBW infants have marginally low birth weight (MLBW, 2000-2500 g) and it is not known whether they benefit from iron supplements. The objective of this trial was to study the effects of iron supplementation in MLBW infants.

Method: In a randomized controlled trial, we assigned 285 healthy, MLBW infants to receive iron supplements at a dose of 0 (placebo), 1, or 2 mg/kg per day between 6 weeks and 6 months of age. Hemoglobin levels, ferritin levels, transferrin saturation, mean cell volume, and transferrin receptor levels were analyzed at 6 months. Growth and morbidity were monitored.

Results: Iron supplementation resulted in significant dose-dependent effects on hemoglobin and all iron status indicators at 6 months. The prevalence of ID at 6 months was 36% in the placebo group, 8.2% in the 1 mg/kg per day group, and 3.8% in the 2 mg/kg per day group (P<.001). The prevalence rates of ID anemia (IDA) were 9.9%, 2.7%, and 0%, respectively (P=.004). Among infants who were exclusively breastfed at 6 weeks, the prevalence of IDA was 18% in the placebo group. There were no significant differences between groups in growth or morbidity.

Conclusions: MLBW infants have relatively high risks of ID and IDA, especially if they are breastfed. Iron supplementation at 2 mg/kg per day from 6 weeks to 6 months reduces this risk effectively, with no short-term adverse effects on morbidity or growth.

Trial registration: ClinicalTrials.gov NCT00558454.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Iron-Deficiency / prevention & control*
  • Breast Feeding
  • Double-Blind Method
  • Female
  • Ferrous Compounds / administration & dosage*
  • Ferrous Compounds / adverse effects
  • Hemoglobins / analysis
  • Humans
  • Infant
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Infant, Premature
  • Iron / administration & dosage
  • Iron / blood
  • Male
  • Transferrin / analysis

Substances

  • Ferrous Compounds
  • Hemoglobins
  • Transferrin
  • ferrous succinate
  • Iron

Associated data

  • ClinicalTrials.gov/NCT00558454