Choudhury Vivek, Amin Sanjiv B, Agarwal Asha, Srivastava L M, Soni Arun, Saluja Satish
Department of Neonatology.
Department of Pediatrics, Division of Neonatology, University of Rochester, Rochester, NY.
Am J Clin Nutr. 2015 Nov;102(5):1030-4. doi: 10.3945/ajcn.115.113084. Epub 2015 Aug 26.
In utero latent iron deficiency has been associated with abnormal neurodevelopmental outcomes during childhood. Its concomitant effect on auditory neural maturation has not been well studied in late preterm and term infants.
The objective was to determine whether in utero iron status is associated with auditory neural maturation in late preterm and term infants.
This prospective cohort study was performed at Sir Ganga Ram Hospital, New Delhi, India. Infants with a gestational age ≥34 wk were eligible unless they met the exclusion criteria: craniofacial anomalies, chromosomal disorders, hemolytic disease, multiple gestation, third-trimester maternal infection, chorioamnionitis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex virus infections (TORCH), Apgar score <5 at 5 min, sepsis, cord blood not collected, or auditory evaluation unable to be performed. Sixty consecutive infants with risk factors for iron deficiency, such as small for gestational age and maternal diabetes, and 30 without risk factors for iron deficiency were enrolled. Absolute wave latencies and interpeak latencies, evaluated by auditory brainstem response within 48 h after birth, were measured and compared between infants with latent iron deficiency (serum ferritin ≤75 ng/mL) and infants with normal iron status (serum ferritin >75 ng/mL) at birth.
Twenty-three infants had latent iron deficiency. Infants with latent iron deficiency had significantly prolonged wave V latencies (7.10 ± 0.68 compared with 6.60 ± 0.66), III-V interpeak latencies (2.37 ± 0.64 compared with 2.07 ± 0.33), and I-V interpeak latencies (5.10 ± 0.57 compared with 4.72 ± 0.56) compared with infants with normal iron status (P < 0.05). This difference remained significant on regression analyses after control for confounders. No difference was noted between latencies I and III and interpeak latencies I-III.
Latent iron deficiency is associated with abnormal auditory neural maturation in infants at ≥34 wk gestational age. This trial was registered at clinicaltrials.gov as NCT02503397.
子宫内潜在缺铁与儿童期异常神经发育结局相关。其对晚期早产儿和足月儿听觉神经成熟的协同影响尚未得到充分研究。
确定子宫内铁状态是否与晚期早产儿和足月儿的听觉神经成熟相关。
这项前瞻性队列研究在印度新德里的甘加拉姆爵士医院进行。胎龄≥34周的婴儿符合入选标准，除非他们符合以下排除标准：颅面畸形、染色体疾病、溶血病、多胎妊娠、孕晚期母体感染、绒毛膜羊膜炎、弓形虫病、其他感染、风疹、巨细胞病毒感染和单纯疱疹病毒感染（TORCH）、5分钟时阿氏评分<5、败血症、未采集脐带血或无法进行听觉评估。连续纳入60例有缺铁风险因素（如小于胎龄儿和母体糖尿病）的婴儿以及30例无缺铁风险因素的婴儿。在出生后48小时内通过听觉脑干反应评估绝对波潜伏期和峰间潜伏期，并对出生时潜在缺铁（血清铁蛋白≤75 ng/mL）的婴儿和铁状态正常（血清铁蛋白>75 ng/mL）的婴儿进行测量和比较。
23例婴儿存在潜在缺铁。与铁状态正常的婴儿相比，潜在缺铁的婴儿V波潜伏期显著延长（分别为7.10±0.68和6.60±0.66），III-V峰间潜伏期（分别为2.37±0.64和2.07±0.33），以及I-V峰间潜伏期（分别为5.10±0.57和4.72±0.56）（P<0.05）。在控制混杂因素后的回归分析中，这种差异仍然显著。I波和III波潜伏期以及I-III峰间潜伏期之间未发现差异。
潜在缺铁与胎龄≥34周婴儿的听觉神经成熟异常相关。该试验已在clinicaltrials.gov注册，注册号为NCT02503397。
