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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.
- Source :
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Neonatology [Neonatology] 2017; Vol. 111 (1), pp. 68-75. Date of Electronic Publication: 2016 Aug 23. - Publication Year :
- 2017
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Abstract
- Background: 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.<br />Objective: 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).<br />Methods: 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.<br />Results: 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.<br />Conclusions: Hyperferritinemia might be associated with oxygen radical diseases and susceptibility to infection.<br /> (© 2016 The Author(s) Published by S. Karger AG, Basel.)
- Subjects :
- Birth Weight
C-Reactive Protein analysis
Female
Gestational Age
Humans
Infant, Newborn
Infant, Very Low Birth Weight blood
Intensive Care Units, Neonatal
Iron Metabolism Disorders blood
Japan
Logistic Models
Male
Multivariate Analysis
Prospective Studies
Bronchopulmonary Dysplasia epidemiology
Ductus Arteriosus, Patent epidemiology
Erythropoietin therapeutic use
Ferritins blood
Iron Metabolism Disorders epidemiology
Iron Overload epidemiology
Sepsis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1661-7819
- Volume :
- 111
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Neonatology
- Publication Type :
- Academic Journal
- Accession number :
- 27547966
- Full Text :
- https://doi.org/10.1159/000447991