Lapillonne A, Becquet O
Service de pédiatrie et réanimation néonatales, hôpital universitaire Necker-Enfants malades, 149 boulevard Sèvres, 75014 Paris, France; Université Paris-Descartes, Paris, France.
Service de pédiatrie et réanimation néonatales, hôpital universitaire Necker-Enfants malades, 149 boulevard Sèvres, 75014 Paris, France.
Arch Pediatr. 2017 May;24(5S):5S40-5S44. doi: 10.1016/S0929-693X(17)24008-1.
Because of the postnatal redistribution of the iron store, the term infant born after an uneventful pregnancy virtually needs no iron during its first 6 months of life. On the other hand, several factors, such as duration of gestation, gender, mother's iron status, alteration of the iron placental transfer, significantly influence the iron store at birth. Because of their reduced body store at birth and their higher demand during catch-up growth, low birth weight infants should receive an iron supplement, which should be started earlier and given at a higher dose in the more premature infants. This preventive strategy can be given as enteral supplement, preterm formula, or enriched breast milk. Finally, because of its benefits on neonatal morbidity and iron status, delayed umbilical cord clamping is recommended for preterm infants.
由于出生后铁储备的重新分布,孕期正常的足月儿在出生后的头6个月实际上不需要铁。另一方面,诸如妊娠期长短、性别、母亲的铁状态、铁经胎盘转运的改变等多种因素,会显著影响出生时的铁储备。低出生体重儿由于出生时体内储备减少且在追赶生长期间需求更高,应补充铁剂,对于更早产的婴儿,补铁应更早开始且剂量更高。这种预防策略可以通过肠内补充剂、早产配方奶或强化母乳来实施。最后,由于延迟脐带结扎对新生儿发病率和铁状态有益,建议对早产儿实施。