Li Mingyan, Ji Chai, Xuan Weifeng, Chen Weijun, Lv Ying, Liu Tingting, You Yuqing, Gao Fusheng, Zheng Quan, Shao Jie
Department of Child Health Care, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Shaoxing Maternal and Child Health Care Hospital, Shaoxing, China.
Front Neurosci. 2021 Nov 8;15:769558. doi: 10.3389/fnins.2021.769558. eCollection 2021.
The aim of the study is to demonstrate the characteristic of motor development and MRI changes of related brain regions in preterm infants with different iron statuses and to determine whether the daily iron supplementation can promote motor development for preterm in early infancy. The 63 preterm infants were grouped into non-anemia with higher serum ferritin (NA-HF) group and anemia with lower serum ferritin (A-LF) group according to their lowest serum Hb level in the neonatal period as well as the sFer at 3 months old. Forty-nine participants underwent MRI scans and Infant Neurological International Battery (INFANIB) at their 3 months. At 6 months of corrected age, these infants received the assessment of Peabody Developmental Motor Scales (PDMS) after 2 mg/kg/day iron supplementation. In total, 19 preterm infants were assigned to the NA-HF group while 44 preterm infants to the A-LF groups. The serum ferritin (sFer) level of the infants in A-LF group was lower than that in NA-HF group (44.0 ± 2.8 mg/L vs. 65.1 ± 2.8 mg/L, < 0.05) and was with poorer scores of INFANIB (66.8 ± 0.9 vs. 64.4 ± 0.6, < 0.05) at 3 months old. The structural connectivity between cerebellum and ipsilateral thalamus in the NA-HF group was significantly stronger than that in the A-LF group ( = 17, 109.76 ± 23.8 vs. = 32, 70.4 ± 6.6, < 0.05). The decreased brain structural connectivity was positively associated with the scores of PDMS ( = 0.347, < 0.05). After 6 months of routine iron supplementation, no difference in Hb, MCV, MCHC, RDW, and sFer was detected between A-LF and NA-HF groups as well as the motor scores of PDMS-2 assessments. Iron status at early postnatal period of preterm infant is related to motor development and the enrichment of brain structural connectivity. The decrease in brain structural connectivity is related to the motor delay. After supplying 2 mg/kg of iron per day for 6 months, the differences in the iron status and motor ability between the A-LF and NA-HF groups were eliminated.
本研究的目的是展示不同铁状态的早产儿运动发育特征及相关脑区的磁共振成像（MRI）变化，并确定每日补充铁剂是否能促进早产儿早期的运动发育。根据新生儿期最低血清血红蛋白水平以及3月龄时的血清铁蛋白（sFer），将63例早产儿分为血清铁蛋白较高的非贫血组（NA-HF）和血清铁蛋白较低的贫血组（A-LF）。49名参与者在3月龄时接受了MRI扫描和国际婴儿神经学检查表（INFANIB）评估。在矫正年龄6个月时，这些婴儿在每日补充2mg/kg铁剂后接受了皮博迪发育运动量表（PDMS）评估。总共，19例早产儿被分配到NA-HF组，44例早产儿被分配到A-LF组。A-LF组婴儿的血清铁蛋白（sFer）水平低于NA-HF组（44.0±2.8mg/L对65.1±2.8mg/L，P<0.05），且在3月龄时INFANIB评分更低（66.8±0.9对64.4±0.6，P<0.05）。NA-HF组小脑与同侧丘脑之间的结构连接性明显强于A-LF组（n=17，109.76±23.8对n=32，70.4±6.6，P<0.05）。脑结构连接性降低与PDMS评分呈正相关（r=0.347，P<0.05）。在进行6个月的常规铁剂补充后，A-LF组和NA-HF组之间在血红蛋白、平均红细胞体积（MCV）、平均红细胞血红蛋白浓度（MCHC）、红细胞分布宽度（RDW）和sFer方面以及PDMS-2评估的运动评分方面均未检测到差异。早产儿出生后早期的铁状态与运动发育及脑结构连接性的富集有关。脑结构连接性降低与运动迟缓有关。在每日补充2mg/kg铁剂6个月后，A-LF组和NA-HF组之间在铁状态和运动能力方面的差异被消除。
