Oral supplementation with Sucrosomial® Iron improves the iron status of preterm piglets delivered by cesarean section†

Premature infants are more likely to develop iron deficiency caused by an inadequate iron storage due to shortened pregnancy. Sucrosomial® Iron (SI) is an oral iron formulation of ferric pyrophosphate with high bioavailability and tolerability. This research compared the iron status of preterm and full-term piglets and evaluated the effects of SI on iron homeostasis in the early postnatal period. Eighteen preterm piglets (born via cesarean section on gestation day 109) and twelve full-term piglets (natural birth) were divided into five groups (n = 6 piglets per group): full-term/preterm piglets without iron supplementation, full-term/preterm piglets supplemented with SI (2 mg Fe per piglet per day, days 4–10), and preterm piglets supplemented with ferrous sulfate (2 mg Fe per piglet per day, days 4–10). Samples were collected on day 11. Preterm piglets showed poor growth and low total body iron content, and they developed iron deficiency anemia, as indicated by decreased red blood cell indices and plasma iron parameters. The iron deficiency was partially improved by SI supplementation. Interestingly, higher hepatic and splenic non-heme iron content, accompanied by increased tissue and plasma ferritin, were found in preterm piglets compared to full-term piglets. SI also contributed to tissue iron accumulation in preterm piglets. Functional iron deficiency and iron accumulation in tissues make the regulation of iron metabolism in preterm piglets different from that in full-term ones. SI can alleviate the negative effects of iron imbalances caused by premature birth by regulating the hepcidin–ferroportin axis. In addition, SI did not induce inflammatory or oxidative responses, and its effects are comparable to those of the classic iron supplement, ferrous sulfate. These results indicate that SI is a promising iron supplement for improving the iron status of premature infants.