Reticulocyte hemoglobin content as a marker of iron deficiency in premature newborns with very low birth weight. A simple tool for diagnosing iron deficiency

Q4 Medicine
D. R. Sharafutdinova, E. N. Balashova, Yu. V. Kessler, Yu. V. Sukhova, A. R. Kirtbaya, А. Yu. Ryndin, T. Yu. Ivanets, O. V. Ionov
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Abstract

Reticulocyte hemoglobin content (RET-He) is a promising marker of iron deficiency (ID) in newborns. Objective: to determine the diagnostic value of RET-He as a marker of ID in premature newborns with very low birth weight (VLBW). We conducted a single-center retrospective cohort study, which included 66 premature infants admitted to the National Medical Research Center for Obstetrics, Gynecology and Perinatology named the Academician V.I. Kulakov of the Ministry of Healthcare of the Russian Federation. Data were obtained from January 2016 to December 2018. The gestational age ranged from 29 to 32 weeks. Laboratory examination included blood tests on the 1 st and 3 rd day of life, then every 10–14 days until the day of life, then every 10–14 days the Institute of Neonatology and Pediatrics; discharge from hospital, and the measurements of serum iron, ferritin, transferrin on the 7 th until the discharge from hospital. This clinical study was approved by the Biomedical Research Ethics Committee (Minutes No.12 of 17 November 2016) and the Scientific Council (Minutes No.19 of 29 November 2016) of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after the Academician V.I. Kulakov of Ministry of Healthcare of the Russian Federation. RET-He was the highest at birth and declined gradually thereafter in premature newborns reaching the lowest values after 3 weeks of life (median (interquartile range) 28.4 (25.8–34.8) pg (on the 1st day of life – 40.0 (35.7–41.9) pg and 33.5 (29.2–36.6) pg at the time of discharge). A low RET-He level was associated with low reticulocytes, with no changes in hemoglobin. There was a positive correlation between RET-He and MCH. D-He decreased from 1 to 42 days of life as a marker of increasing anemia. There was a negative correlation between RET-He and Hypo-He (p < 0.005). Starting from 42 days of life, or by the time of discharge, 32% of premature infants (n = 21) had a low ferritin level and 77% (n = 51) of premature infants had a low RET-He level, of which 21 infants developed ID (a positive correlation between RET-He and ferritin after 42 days of life (r = 0.34, p = 0.046)). There was no correlation between RET-He and ferritin in newborns without ID. Also, there were no correlations between RET-He and iron and RET-He and transferrin. After 42 days of life, RET-He less than 28.4 pg was a marker of ID (sensitivity 83.3% and specificity 93.7%). Low RET-He, D-He, RBC-Hе and high microR, Hypo-He were the earliest markers of ID in premature infants which predicted a decrease in serum iron and ferritin levels. RET-He, D-Не and Hypo-He are biomarkers with accurate diagnostic value of ID in premature infants with VLBW.
网状红细胞血红蛋白含量作为极低出生体重早产儿缺铁的标志。一个诊断缺铁的简单工具
网织红细胞血红蛋白含量(RET-He)是新生儿缺铁(ID)的一个有希望的标志物。目的:探讨RET-He在极低出生体重早产儿(VLBW)中的诊断价值。我们进行了一项单中心回顾性队列研究,纳入了俄罗斯联邦卫生部V.I. Kulakov院士命名的国家产科、妇科和围产期医学研究中心的66名早产儿。数据取自2016年1月至2018年12月。胎龄29 ~ 32周。实验室检查包括在出生后第1天和第3天进行血液检查,然后在出生前每10-14天进行一次血液检查,然后在新生儿和儿科研究所每10-14天进行一次血液检查;出院后,7日至出院前测定血清铁、铁蛋白、转铁蛋白。该临床研究得到了以俄罗斯联邦卫生部院士V.I. Kulakov命名的国家妇产科和围产期医学研究中心生物医学研究伦理委员会(2016年11月17日第12号会议纪要)和科学委员会(2016年11月29日第19号会议纪要)的批准。RET-He在出生时最高,随后逐渐下降,在出生3周后达到最低(中位数(四分位数范围)28.4 (25.8-34.8)pg(出生第1天为40.0 (35.7-41.9)pg,出院时为33.5 (29.2-36.6)pg)。低RET-He水平与低网织红细胞相关,血红蛋白无变化。RET-He与MCH呈正相关。D-He从1天减少到42天,作为贫血增加的标志。RET-He与hypohe呈负相关(p <0.005)。从出生42天或出院时,32%的早产儿(n = 21)存在低铁蛋白水平,77%的早产儿(n = 51)存在低RET-He水平,其中21例发生ID(42天后RET-He与铁蛋白呈正相关(r = 0.34, p = 0.046))。无ID新生儿RET-He与铁蛋白无相关性。RET-He与铁、RET-He与转铁蛋白无相关性。42天后,RET-He小于28.4 pg是ID的标志(敏感性83.3%,特异性93.7%)。低RET-He、D-He、rbc - hvir和高microR、hypohe是早产儿ID的最早标志,预示着血清铁和铁蛋白水平的下降。RET-He、D-Не和hypohe是对VLBW早产儿ID有准确诊断价值的生物标志物。
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来源期刊
Pediatric Hematology/Oncology and Immunopathology
Pediatric Hematology/Oncology and Immunopathology Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.40
自引率
0.00%
发文量
49
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