title: Intravenous iron administration to very-low-birth-weight newborns receiving total and partial parenteral nutrition.
abstract: BACKGROUND
  Intravenous iron supplements are not routinely administered to very-low-birth-weight newborns receiving total parenteral nutrition because of the possible increased risk of infection and because iron needs may be met with blood transfusions.
  
  
  METHODS
  To assess the benefits of a prudent IV iron supplement (200 to 250 micrograms/kg/d), 26 very-low-birth-weight newborns (birth weight, 1005 +/- 302 g; gestational age, 28 +/- 2.3 weeks; mean +/- SD) were randomly allocated to receive total parenteral nutrition without iron (No-Iron) or with iron supplied as iron dextran (Iron). These newborns were followed at baseline (2 to 3 days after birth) and at weeks 1 to 4 thereafter. At each sampling time, urine samples, fecal samples (rarely), unused total parenteral nutrition solutions, blood products, and a blood sample (1 mL) were collected.
  
  
  RESULTS
  There were no differences between the two groups in anthropometric measurements, hematologic or biochemical parameters, number or amount of blood transfusions (2.3 +/- 1.9), amount of blood removed for diagnostic purposes (44 +/- 16 mL), or number of septic events (n = 16). There was no difference between the groups for the total iron excreted; however, the Iron group retained more iron. Iron balance was negative for all but 10 newborns (No-Iron, 3; Iron, 7) throughout the study.
  
  
  CONCLUSIONS
  A total iron intake of 400 micrograms/kg/d, half of which was provided by IV iron, is not sufficient to maintain iron balance or to meet fetal accretion rates (1000 micrograms/kg/d) in very-low-birth-weight newborns receiving total parenteral nutrition. Furthermore, endogenous iron from blood transfusions does not provide an adequate supply of iron.
authors.affiliation: Department of Pediatrics, Memorial University of Newfoundland, St. John's, Canada.
authors.forename: J K
authors.initials: JK
authors.lastname: Friel
authors.forename: W L
authors.initials: WL
authors.lastname: Andrews
authors.forename: M S
authors.initials: MS
authors.lastname: Hall
authors.forename: M S
authors.initials: MS
authors.lastname: Rodway
authors.forename: M
authors.initials: M
authors.lastname: Keith
authors.forename: U C
authors.initials: UC
authors.lastname: McCloy
authors.forename: J D
authors.initials: JD
authors.lastname: Matthew
authors.forename: D R
authors.initials: DR
authors.lastname: Long
mesh_terms: D000886:Anthropometry; D005527:Food, Fortified; D006801:Humans; D007230:Infant, Low Birth Weight / Q000378:metabolism*; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007501:Iron / Q000008:administration & dosage*; D010288:Parenteral Nutrition / Q000379:methods / Q000592:standards*
chemical_list: D007501:Iron