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Effects of iron supplements and perinatal factors on fetal hemoglobin disappearance in LBW infants
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Department of Women and Child Health, Division of Neonatology, Karolinska Institute, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
2014 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 76, no 5, 477-482 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:The homeostatic mechanisms of iron metabolism and erythropoiesis in infants are unclear. Infants synthesize both fetal hemoglobin (HbF) and adult hemoglobin (HbA), and it is not known how the hemoglobin switch is regulated. We hypothesized that iron supplements to infants affect the disappearance of HbF. METHODS: We randomized 285 low-birth-weight infants (2,000-2,500g) into three intervention groups receiving 0, 1, or 2 mg/kg/d of iron supplements from 6 wk to 6 mo of age. In the present secondary analysis, we analyzed iron status, total hemoglobin (Hb), and HbF fraction at 6 wk, 12 wk, and at 6 mo and calculated absolute levels of HbF. RESULTS: We observed dose-dependent increased levels of Hb in iron-supplemented groups at 6 mo of age. However, for absolute HbF concentration, there was no similar effect of intervention. Mean (SD) HbF was 81.2 (16.8), 37.0 (13.8), and 8.1 (5.6) g/l at 6 wk, 12 wk, and 6 mo, respectively, similar in all groups. In linear regression analyses, postconceptional age turned out as the major predictor of HbF, independent of gestational age at birth. CONCLUSION: Our hypothesis was rejected. Instead, we confirmed a close correlation to postconceptional age, supporting a genetically programmed switch, insensitive to most environmental factors including birth.

Place, publisher, year, edition, pages
Nature Publishing Group, 2014. Vol. 76, no 5, 477-482 p.
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Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-97228DOI: 10.1038/pr.2014.116ISI: 000344512200010PubMedID: 25119339OAI: oai:DiVA.org:umu-97228DiVA: diva2:773269
Available from: 2014-12-18 Created: 2014-12-12 Last updated: 2017-12-05Bibliographically approved

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CiteExportLink to record
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