TY - JOUR
T1 - Iron homeostasis disruption and oxidative stress in preterm newborns
AU - Raffaeli, Genny
AU - Manzoni, Francesca
AU - Cortesi, Valeria
AU - Cavallaro, Giacomo
AU - Mosca, Fabio
AU - Ghirardello, Stefano
PY - 2020/6
Y1 - 2020/6
N2 - Iron is an essential micronutrient for early development, being involved in several cellular processes and playing a significant role in neurodevelopment. Prematurity may impact on iron homeostasis in different ways. On the one hand, more than half of preterm infants develop iron deficiency (ID)/ID anemia (IDA), due to the shorter duration of pregnancy, early postnatal growth, insufficient erythropoiesis, and phlebotomy losses. On the other hand, the sickest patients are exposed to erythrocytes transfusions, increasing the risk of iron overload under conditions of impaired antioxidant capacity. Prevention of iron shortage through placental transfusion, bloodsparing practices for laboratory assessments, and iron supplementation is the first frontier in the management of anemia in preterm infants. The American Academy of Pediatrics recommends the administration of 2 mg/kg/day of oral elemental iron to human milk-fed preterm infants from one month of age to prevent ID. To date, there is no consensus on the type of iron preparations, dosages, or starting time of administration to meet optimal cost-efficacy and safety measures. We will identify the main determinants of iron homeostasis in premature infants, elaborate on ironmediated redox unbalance, and highlight areas for further research to tailor the management of iron metabolism.
AB - Iron is an essential micronutrient for early development, being involved in several cellular processes and playing a significant role in neurodevelopment. Prematurity may impact on iron homeostasis in different ways. On the one hand, more than half of preterm infants develop iron deficiency (ID)/ID anemia (IDA), due to the shorter duration of pregnancy, early postnatal growth, insufficient erythropoiesis, and phlebotomy losses. On the other hand, the sickest patients are exposed to erythrocytes transfusions, increasing the risk of iron overload under conditions of impaired antioxidant capacity. Prevention of iron shortage through placental transfusion, bloodsparing practices for laboratory assessments, and iron supplementation is the first frontier in the management of anemia in preterm infants. The American Academy of Pediatrics recommends the administration of 2 mg/kg/day of oral elemental iron to human milk-fed preterm infants from one month of age to prevent ID. To date, there is no consensus on the type of iron preparations, dosages, or starting time of administration to meet optimal cost-efficacy and safety measures. We will identify the main determinants of iron homeostasis in premature infants, elaborate on ironmediated redox unbalance, and highlight areas for further research to tailor the management of iron metabolism.
KW - Anemia
KW - Blood-sparing
KW - Iron
KW - Prematurity
KW - Redox unbalance
KW - Transfusion
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U2 - 10.3390/nu12061554
DO - 10.3390/nu12061554
M3 - Article
C2 - 32471148
AN - SCOPUS:85085904536
VL - 12
JO - Nutrients
JF - Nutrients
SN - 2072-6643
IS - 6
M1 - 1554
ER -