title: An Elevation of Serum Ferritin Level Might Increase Clinical Risk for the Persistence of Patent Ductus Arteriosus, Sepsis and Bronchopulmonary Dysplasia in Erythropoietin-Treated Very-Low-Birth-Weight Infants.
abstract: The substantial risk of iron overload is not routinely monitored in most of the neonatal intensive care units (NICUs) in Japan; however, blood transfusion is an essential strategy for successfully treating preterm low-birth-weight infants.
  
  
  
  The aim of this study was to investigate the iron status and clinical features of infants with a birth weight of <1,500 g, i.e. very-low-birth-weight infants (VLBWIs).
  
  
  
  This prospective observational study enrolled 176 (82.6%) patients from a total of 213 VLBWIs admitted to our NICU from 2009 to 2014. Clinical information was collected including maternal records and infant morbidity and treatment. Management strategies including enteral iron supplementation, erythropoietin administration and blood transfusion were allowed according to the consensus in Japan. The hematological status was surveyed from birth to 12 postnatal weeks of age. The iron status was determined according to serum iron, unbound iron-binding capacity and serum ferritin. The definition of hyperferritinemia was set as a value of ≥500 ng/ml.
  
  
  
  Twenty-four (13.6%) infants displayed hyperferritinemia. A multiple logistic analysis selected 3 associated factors of hyperferritinemia: surgical ligation for patent ductus arteriosus, sepsis and moderate or severe states of bronchopulmonary dysplasia. We also verified that the value of ferritin was significantly correlated with those of aspartate transaminase, creatine kinase and C-reactive protein according to a multilinear regression analysis. After excluding the ferritin data of these outliers, we did not observe any factors associated with hyperferritinemia.
  
  
  
  Hyperferritinemia might be associated with oxygen radical diseases and susceptibility to infection.
authors.affiliation: Centers of Comprehensive Maternity and Perinatal Care, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ochiai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kurata
authors.forename: Hirosuke
authors.initials: H
authors.lastname: Inoue
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsushita
authors.forename: Junko
authors.initials: J
authors.lastname: Fujiyoshi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Wakata
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kato
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Taguchi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Takada
mesh_terms: D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000032:analysis; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005293:Ferritins / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood; D007363:Intensive Care Units, Neonatal; D019189:Iron Metabolism Disorders / Q000097:blood / Q000453:epidemiology*; D019190:Iron Overload / Q000453:epidemiology*; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology*
chemical_list: D004921:Erythropoietin; D002097:C-Reactive Protein; D005293:Ferritins