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American Journal of Clinical Nutrition, Vol. 86, No. 1, 64-73, July 2007
© 2007 American Society for Nutrition


ORIGINAL RESEARCH COMMUNICATION

Predictors of serum ferritin and serum soluble transferrin receptor in newborns and their associations with iron status during the first 2 y of life1,2,3

Gry Hay, Helga Refsum, Andrew Whitelaw, Elisabeth Lind Melbye, Egil Haug and Berit Borch-Iohnsen

1 From the Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway (GH, HR, ELM, and BB-I); the Aker University Hospital, Oslo, Norway (EH); and the Department of Clinical Science, University of Bristol, Bristol, United Kingdom (AW)

Background: Adequate iron status at birth may prevent iron deficiency in early childhood.

Objectives: We aimed to identify predictors of serum ferritin (SF) and serum soluble transferrin receptor (sTfR) in healthy newborns and to relate these iron indexes to iron status in the first 2 y of life.

Design: Using bivariate correlations and linear regression, we related various factors in pregnancy to SF (n = 363) and sTfR (n = 350) in healthy, term infants. Measurements of cord SF and sTfR were compared with those of SF and sTfR at 6, 12, and 24 mo. All 4 measurements were available for 191 and 169 infants for SF and sTfR, respectively.

Results: Geometric mean (and 95% CI) cord SF and sTfR measurements were 159 (148, 171) µg/L and 7.3 (7.0, 7.6) mg/L, respectively. Cord SF correlated with sTfR ({rho} = –0.21, P < 0.001). In regression analysis, cord SF correlated with smoking and the use of iron supplements during pregnancy (partial r = –0.12 and 0.16; P < 0.05 for both). Cord sTfR was associated with first trimester BMI, gestational age, and male sex (partial r = 0.30, 0.24, and 0.19, respectively; P < 0.01 for all). Cord SF correlated with SF at 6, 12, and 24 mo ({rho} = 0.45, 0.31, and 0.16 respectively; P < 0.05 for all). At age 6 mo, 16 of 17 infants with SF <15 µg/L were boys.

Conclusions: Cessation of smoking and adequate iron prophylaxis during pregnancy may improve iron status in infancy. Cord SF is a predictor of iron status in the first 2 y of life. Boys are at particular risk of low iron status in early infancy.

Key Words: Iron status • iron deficiency • iron supplementation • serum ferritin • serum transferrin receptor • pregnancy • newborns • children • cord blood




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