Neonatology Unit, Department of Woman and Child Health and Public Health, Child Health Area, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, Rome, Italy.
Pediatric Neurology Unit, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
Eur J Pediatr. 2022 Jan;181(1):295-302. doi: 10.1007/s00431-021-04181-1. Epub 2021 Jul 21.
Late-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and iron deficiency. The aim of the study is to assess the positive effect of iron supplementation on psychomotor development in healthy LPT. We designed a randomized placebo-controlled double-blind trial dividing the newborns into two groups. Every patient was assessed using the Griffiths Mental Development Scales (GMDS)-II edition at 12-month post-conceptional age. The study was performed at the Neonatology Unit of our Hospital, in Italy. Sixty-six healthy LPT infants born between 34 and 36 weeks of gestational age were enrolled in the study. One group received martial prophylaxis from the third week of life to 6 months of post-conceptional age (2 mg/kg/day of iron pidolate), the other received placebo. Fifty-two of the enrolled infants were assessed using the GMDS at 12-month of post-conceptional age. Statistical analysis of the mean scores of the Griffiths subscales was performed. There was a difference in the mean developmental quotient (DQ) (p < 0.01) between the two groups: iron group mean DQ 121.45 ± 10.53 vs placebo group mean DQ 113.25 ± 9.70. Moreover, mean scores of the Griffiths subscales A, B, and D showed significant differences between the two groups (scale A p < 0.05, scale B p < 0.02, scale D p < 0.01, respectively).Conclusions: We recommend that all LPT neonates receive iron supplementation during the first 6 months of life in order to improve their 1-year neurodevelopmental quotient. What is Known: • Late-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and also for iron deficiency. • Iron deficiency is an independent risk factor for adverse neurological outcomes. What is New: • Healthy late-preterm who received iron supplementation during the first 6 months of life achieved better neurological outcomes at 12-month post-conceptional age than LPT who received placebo. • Our study strongly supports the need for the implementation of martial prophylaxis in LPT neonates.
晚期早产儿（LPT）患长期神经发育后遗症和缺铁的风险增加。本研究旨在评估铁补充对健康 LPT 精神运动发育的积极影响。我们将新生儿分为两组，进行了一项随机安慰剂对照双盲试验。每位患者在出生后 12 个月时均使用 Griffiths 精神发育量表（GMDS）-II 版进行评估。该研究在意大利我们医院的新生儿科进行。共纳入 66 例胎龄 34 至 36 周的健康 LPT 婴儿。一组从出生后第 3 周开始至 6 个月龄时接受铁预防性治疗（2mg/kg/天的 pidolate 铁），另一组接受安慰剂。在出生后 12 个月时，52 名入组婴儿接受 GMDS 评估。对 Griffiths 子量表的平均分数进行了统计学分析。两组间发育商（DQ）的平均值存在差异（p<0.01）：铁组平均 DQ 为 121.45±10.53，安慰剂组平均 DQ 为 113.25±9.70。此外，两组间 Griffiths 量表 A、B 和 D 的平均得分存在显著差异（量表 A p<0.05，量表 B p<0.02，量表 D p<0.01）。结论：我们建议所有 LPT 新生儿在生命的前 6 个月内接受铁补充治疗，以提高其 1 岁时的神经发育商。已知：•晚期早产儿（LPT）患长期神经发育后遗症和缺铁的风险增加。•缺铁是不良神经结局的独立危险因素。新内容：•接受铁补充治疗的健康晚期早产儿在出生后 6 个月内的神经发育结果优于接受安慰剂的晚期早产儿。•我们的研究强烈支持在 LPT 新生儿中实施铁预防性治疗。
