Zinc protoporphyrin/heme ratio as parameter of iron status in moderately preterm infants: natural course and associations in the first 4 months.
To determine the natural course of zinc protoporphyrin/heme ratio (ZnPP/H) and its role in the detection of iron deficiency (ID) and iron-deficiency anemia (IDA) in the first 4 months of life in moderately preterm infants.



ZnPP/H was measured at 1 week, 6 weeks and 4 months postnatal age in a prospective cohort of 161 Dutch infants born at a gestational age of 32+0 to 36+6 weeks who did not receive an erythrocyte transfusion or iron supplementation.



ZnPP/H levels decreased in the first 6 weeks and increased thereafter. At 4 months postnatal age, ZnPP/H was higher in the 11 (8.5%) infants with IDA (mean (s.d.): 260.8 (16.1)) but not in the 27 (21.3%) infants with ID (mean (s.d.): 177.0 (15.1)) compared with normal infants (mean (s.d.): 157.3 (12.5)).



In moderately preterm infants, ZnPP/H can be of additional value to detect infants at risk for IDA due to iron-deficient erythropoiesis at 4 months of age.
Department of Pediatrics, Juliana Children's Hospital, HAGA Teaching Hospital, The Hague, The Netherlands.|Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
C G
CG
de Waal
Department of Pediatrics, Juliana Children's Hospital, HAGA Teaching Hospital, The Hague, The Netherlands.|Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
L
L
Uijterschout
Department of Pediatrics, Medical Center Alkmaar, Alkmaar, The Netherlands.
M
M
Abbink
Department of Pediatrics, Medical Center Alkmaar, Alkmaar, The Netherlands.
B
B
Boersma
Department of Pediatrics, Medical Center Haaglanden, The Hague, The Netherlands.
P
P
Vos
Department of Pediatrics, Juliana Children's Hospital, HAGA Teaching Hospital, The Hague, The Netherlands.
W W
WW
Rövekamp
Department of Clinical Chemistry, LabWest, HAGA Teaching Hospital, The Hague, the Netherlands.
F
F
Hudig
Department of Pediatrics, Juliana Children's Hospital, HAGA Teaching Hospital, The Hague, The Netherlands.
M D
MD
Akkermans
Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.|Department of Pediatrics, VU University Medical Center, Amsterdam, the Netherlands.
J B
JB
van Goudoever
Department of Pediatrics, Juliana Children's Hospital, HAGA Teaching Hospital, The Hague, The Netherlands.
F
F
Brus
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis*; D005260:Female; D005293:Ferritins / Q000097:blood; D005865:Gestational Age; D006403:Hematologic Tests; D006418:Heme / Q000032:analysis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D016014:Linear Models; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D011524:Protoporphyrins / Q000097:blood*; D012372:ROC Curve
D011524:Protoporphyrins; C017803:zinc protoporphyrin; D006418:Heme; D005293:Ferritins; D007501:Iron