title: Gestational age-specific reference ranges of hepcidin in cord blood.
abstract: BACKGROUND
  Iron deficiency (ID) contributes to anaemia of prematurity, and hence the reliable assessment of iron nutrition status appears to be mandatory.
  
  
  OBJECTIVE
  To establish gestational age (GA)-specific reference ranges for hepcidin concentrations in cord blood [Hep(CB)] of preterm and term infants and to identify pre- and perinatal confounding factors.
  
  
  METHODS
  This is a prospective observational study including 221 infants (GA at birth: 24-42 weeks). Hep(CB) along with complete blood counts, ferritin and parameters of inflammation and clinical data were recorded. Data are presented as medians (IQR).
  
  
  RESULTS
  The Hep(CB) of very preterm infants (GA <30 weeks, n = 40) was 26.9 ng/ml (13.5-63.1), for moderately preterm infants (GA 30-36 weeks, n = 81) it was 45.9 ng/ml (24.7-74.5) and for term infants (GA ≥37 weeks, n = 100) it was 103.9 ng/ml (61.4-149.2). The Hep(CB) of infants with ID was lower [36.9 ng/ml (18.0-58.3)] than that of iron-replete infants [86.6 ng/ml (51.9-143.8)]. The Hep(CB) of infants delivered by elective caesarean section was lower [38.3 ng/ml (15.5-73.7)] than that of infants after spontaneous vaginal delivery or secondary caesarean section [80.3 ng/ml (48.5-137.6)]. Infants with a standard deviation score for birth weight (SDSBW) <-2 had a lower Hep(CB) [23.1 ng/ml (11.7-61.5)] compared to infants with SDSBW ≥-2 [71.1 ng/ml (34.0-121.7)]. The highest Hep(CB) (437.6 ng/ml) was recorded in an infant with Enterococcus faecalis sepsis. Multiple logistic regression analysis confirmed ferritin, GA and mode of delivery as important factors associated with Hep(CB).
  
  
  CONCLUSIONS
  This is the first report on GA-specific reference ranges for Hep(CB) in preterm infants. Whereas iron stores, GA and mode of delivery were associated with Hep(CB), the association with inflammation and intra-uterine growth retardation was less clear.
authors.affiliation: Department of Neonatology, University Children's Hospital of Tübingen, Tübingen, Germany.
authors.forename: Laila
authors.initials: L
authors.lastname: Lorenz
authors.forename: Johanna
authors.initials: J
authors.lastname: Herbst
authors.forename: Corinna
authors.initials: C
authors.lastname: Engel
authors.forename: Andreas
authors.initials: A
authors.lastname: Peter
authors.forename: Harald
authors.initials: H
authors.lastname: Abele
authors.forename: Christian F
authors.initials: CF
authors.lastname: Poets
authors.forename: Mark
authors.initials: M
authors.lastname: Westerman
authors.forename: Axel R
authors.initials: AR
authors.lastname: Franz
mesh_terms: D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D013293:Enterococcus faecalis / Q000302:isolation & purification; D005260:Female; D005293:Ferritins / Q000097:blood; D005312:Fetal Blood / Q000737:chemistry*; D005317:Fetal Growth Retardation / Q000097:blood / Q000175:diagnosis; D005865:Gestational Age; D016908:Gram-Positive Bacterial Infections / Q000097:blood / Q000175:diagnosis / Q000382:microbiology; D006454:Hemoglobins / Q000032:analysis; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D007230:Infant, Low Birth Weight / Q000097:blood; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D018836:Inflammation Mediators / Q000097:blood; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D018805:Sepsis / Q000097:blood / Q000175:diagnosis / Q000382:microbiology
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D064451:Hepcidins; D018836:Inflammation Mediators; D005293:Ferritins