Effects of early iron supplementation on the occurrence of anaemia in low birth weight newborns admitted to the neonatal intensive care unit at The University Teaching Hospital

Abstract

Effect of early iron supplementation on the occurrence of anaemia in low birth weight newborns admitted to the Neonatal Intensive Care Unit at University Teaching Hospital. Background: Iron deficiency is the most common single nutrient disorder in the world. As with all nutrients, the requirement for iron is greater during periods of rapid growth and differentiation such as late foetal and neonatal period. Anaemia in very low birth weight preterm infants maybe related to relative deficiency of erythropoietin (EPO), and clinical trials indicate that premature infants who do not have severe illness and are treated with recombinant human EPO and iron during the first 6 weeks of life require fewer transfusions. Objective: To determine whether early iron supplementation reduces rates of anaemia and blood transfusions as well as duration of admission in low birth weight infants with weights between 1 and 2 kg at the NICU, UTH, Zambia. Methods: This was an Open-label single intervention randomised trial with a follow up period of 28 days from time of entry. Infants were randomly assigned to receive enteral iron supplementation of 2 mg/kg at 1 week of age and when enteral feeds where at 100ml/kg/day (early group, EI) or at 28 days of age (late enteral iron supplementation, LI).As a measure of anaemia, haematocits were checked every week until week four of follow up. Blood transfusion was given following NICU protocols i.e. infants were transfused at haematocrit of 35 or below. Duration of stay was determined from the date of admission to the time of discharge. The primary outcomes were; (1) Haematocrit at 28 days of follow up (2) Proportion of transfusions in the two groups at 28 days of follow up. Data analysis was done using SPSS version 20. Results: Results showed a mean haematocrit of 35.0% in the early iron group and 35.2% in the late iron group (p>0.5) at end of follow up. There was no significant difference in the number of transfusions with 3(4.9%) in the early iron group and 4(6.5%) in the late iron group. Length of hospital stay was similar in the two groups with a mean of 16.1 in the early iron group and 15.8 in the late iron group (p>0.5) Conclusion: The results show that anaemia does not improve when iron is supplemented earlier than 28 days in low birth weight newborns