Serum ferritin values in neonates <29 weeks' gestation are highly variable and do not correlate with reticulocyte hemoglobin content

J Perinatol. 2023 Nov;43(11):1368-1373. doi: 10.1038/s41372-023-01751-z. Epub 2023 Aug 18.

Abstract

Objectives: To compare serum ferritin and RET-He values among extremely low gestational age neonates ELGANs with other markers of iron-deficient erythropoiesis.

Study design: This is a secondary analysis of the NICHD Darbepoetin Trial. Study data from placebo recipients who had a serum ferritin, a RET-He, and a mean corpuscular volume (MCV) measurement within a 24-hour period were analyzed for correlation.

Results: Mixed linear regression models showed no association between ferritin and RET-He at both early (β = 0.0016, p = 0.40) and late (β = -0.0001, p = 0.96) time points. Positive associations were observed between RET-He and MCV at baseline, early, and late time points (p < 0.01, =0.01, <0.001, respectively), while ferritin was not associated with MCV at any time point.

Conclusions: Our study shows that RET-He is better correlated with MCV as a marker of iron-limited erythropoiesis than ferritin. The results suggest that ferritin is limited as a marker of iron sufficiency in premature infants.

Study identification: FDA IND Number 100138; ClinicalTrials.gov number NCT03169881; NRN ID number NICHD-NRN-0058 (Darbe).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anemia, Iron-Deficiency* / drug therapy
  • Female
  • Ferritins
  • Gestational Age
  • Hemoglobins / analysis
  • Humans
  • Infant
  • Infant, Newborn
  • Iron
  • Pregnancy
  • Reticulocytes* / chemistry
  • Reticulocytes* / metabolism

Substances

  • Iron
  • Hemoglobins
  • Ferritins

Associated data

  • ClinicalTrials.gov/NCT03169881