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Marginally Low Birth Weight Ups Iron Deficiency Risk

Supplementation with iron drops prevents anemia in these babies without growth, morbidity effects

THURSDAY, Sept. 9 (HealthDay News) -- Iron supplementation at 2 mg/kg per day from 6 weeks to 6 months of age reduces the elevated risk of iron deficiency (ID) and iron deficiency anemia (IDA) in marginally low birth weight (MLBW) infants, without short-term adverse effects on growth or morbidity, according to a study published online Sept. 6 in Pediatrics.

Staffan Berglund, M.D., of Umeå University in Sweden, and colleagues conducted a randomized controlled trial of 285 healthy MLBW infants to determine whether this subgroup, like other low birth weight infants, is at high risk for ID and IDA. The researchers also aimed to determine whether routine iron supplementation from 6 weeks of age to 6 months of age might prevent IDA from occurring in this group. MLBW infants received either no iron supplementation (placebo), 1 mg/kg per day, or 2 mg/kg per day.

The researchers found that, at 6 months, iron supplementation had a significant, dose dependent effect on laboratory iron status indicators (hemoglobin, ferritin, transferrin saturation, mean cell volume, and transferrin receptor levels). The placebo group had a 36 percent prevalence of ID and a 9.9 percent prevalence of IDA at 6 months, compared to a 3.8 percent ID prevalence and a 0 percent IDA prevalence in the 2 mg/kg/day group and an 8.2 percent ID prevalence and a 2.7 percent IDA prevalence in the 1 mg/kg/day group. For infants exclusively breast-fed at 6 weeks, the IDA prevalence in the placebo group was nearly doubled (18 percent). No growth or morbidity differences were observed between the groups.

"For the first time, we have shown that MLBW infants, who represent 3 to 5 percent of all newborn infants in affluent countries, have a relatively high risk of developing IDA, even if they are otherwise healthy and well nourished. This can be prevented effectively with iron drops at a dose of 2 mg/kg per day from 6 weeks to 6 months, a supplementation that we conclude to be safe with respect to growth and morbidity," the authors write.

Astra Zeneca provided the iron supplementation drops used in the study.

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