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


METHODS
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.
Berglund
Staffan
S
Umeå University, Department of Clinical Sciences, Division of Pediatrics, SE-901 85 Umeå, Sweden.
Westrup
Björn
B
Domellöf
Magnus
M
D018798:Anemia, Iron-Deficiency / Q000517:prevention & control*; D001942:Breast Feeding; D004311:Double-Blind Method; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007501:Iron / Q000008:administration & dosage / Q000097:blood; D008297:Male; D014168:Transferrin / Q000032:analysis
D005296:Ferrous Compounds; D006454:Hemoglobins; D014168:Transferrin; C022943:ferrous succinate; D007501:Iron