Department of Pediatrics, Division of Neonatology, University of Utah Health, Salt Lake City, UT, USA.
Department of Pediatrics, Division of Neonatology, University of Utah Health, Salt Lake City, UT, USA.
Blood Cells Mol Dis. 2021 Sep;90:102575. doi: 10.1016/j.bcmd.2021.102575. Epub 2021 May 6.
In order to reduce iron deficiency in neonates at-risk for iron deficiency, we implemented a guideline to increase the consistency of early iron supplementation in infants of diabetic mothers, small for gestational age neonates and very low birthweight premature neonates. Three years following implementation we performed a retrospective analysis in order to assess adherence to the guideline and to compare timing of early iron supplementation and reticulocyte-hemoglobin (RET-He) values at one month of life in at-risk infants. Adherence with early iron supplementation guidelines was 73.4% (399/543) with 51% (275/543) having RET-He values obtained at one month. Despite good adherence, 16% (44/275) had RET-He <25 pg (5th percentile for gestational age). No infants receiving red blood cell transfusion (0/20) had RET-He <25 pg vs. 26.1% (40/153) of those treated with darbepoetin (p < 0.001). There was no evidence of increased feeding intolerance (episodes of emesis/day) with early iron supplementation.
为了降低高危新生儿缺铁的风险，我们实施了一项指南，以增加补充铁的一致性，对象为患有糖尿病的母亲所生的婴儿、小于胎龄儿和极低出生体重早产儿。在实施三年后，我们进行了一项回顾性分析，以评估对该指南的遵循情况，并比较高危婴儿在一个月大时的早期铁补充和网织红细胞血红蛋白（RET-He）值的时间。早期铁补充指南的遵循率为 73.4%（399/543），51%（275/543）的婴儿在一个月时获得了 RET-He 值。尽管遵循情况良好，但仍有 16%（44/275）的婴儿 RET-He<25pg（胎龄第 5 百分位数）。接受红细胞输注的婴儿（0/20）中没有 RET-He<25pg 的情况，而接受达贝泊汀治疗的婴儿中则有 26.1%（40/153）（p<0.001）。早期铁补充并没有增加喂养不耐受（每天呕吐发作次数）的证据。
