title: Evaluating iron status and the risk of anemia in young infants using erythrocyte parameters.
abstract: BACKGROUND
  Correct evaluation of iron status is important in young infants because both iron deficiency and excess may have negative effects on development, growth, and morbidity.
  
  
  METHODS
  We evaluated iron status using erythrocyte parameters, including reticulocyte hemoglobin content (CHr) in infants with birth weight <3,000 g (n = 80). Blood samples and infant characteristics were recorded at 6 wk and at 4 and 6 months. Infants with a birth weight ≤2,500 g (n = 36) were recommended for iron supplementation.
  
  
  RESULTS
  Despite a significantly poorer status at 6 wk, iron-supplemented infants had significantly higher hemoglobin level (Hb): 12.2 (SD = 0.8) g/dl and CHr: 28.3 (SD = 1.4) pg at 6 mo, as compared with nonsupplemented infants, Hb: 11.7 (SD = 1.0) g/dl, P = 0.02 and CHr: 26.5 (SD = 2.5) pg, P < 0.001. Prolonged exclusive breastfeeding, high weight gain, and male gender were the predisposing factors for a low iron status at 6 mo. A CHr cutoff level of 26.9 pg at 4 mo proved to be a sensitive predictor for anemia at 6 mo.
  
  
  CONCLUSIONS
  Signs of an iron-restricted erythropoiesis were observed in nonsupplemented infants (birth weight 2,501-3,000 g), and CHr was a useful tool for evaluating iron status. The need for iron supplementation in certain infant risk populations should be further evaluated.
authors.affiliation: Department of Pediatrics, Haukeland University Hospital, Bergen, Norway. idto@helse-bergen.no
authors.forename: Ingrid Kristin
authors.initials: IK
authors.lastname: Torsvik
authors.forename: Trond
authors.initials: T
authors.lastname: Markestad
authors.forename: Per Magne
authors.initials: PM
authors.lastname: Ueland
authors.forename: Roy M
authors.initials: RM
authors.lastname: Nilsen
authors.forename: Oivind
authors.initials: O
authors.lastname: Midttun
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Bjørke Monsen
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D001942:Breast Feeding; D016009:Chi-Square Distribution; D019587:Dietary Supplements; D004906:Erythrocyte Count; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000187:drug effects / Q000378:metabolism*; D004920:Erythropoiesis / Q000187:drug effects; D005260:Female; D005296:Ferrous Compounds / Q000627:therapeutic use; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D007501:Iron / Q000097:blood*; D008297:Male; D017711:Nonlinear Dynamics; D009664:Norway; D011237:Predictive Value of Tests; D011379:Prognosis; D012156:Reticulocytes / Q000378:metabolism; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D015430:Weight Gain
chemical_list: D015415:Biomarkers; D005296:Ferrous Compounds; D006454:Hemoglobins; D007501:Iron; C031621:ferrous fumarate