The iron status in the infants of diabetic and preeclamptic mothers in early infancy

SUMMARYTHE IRON STATUS IN THE INFANTS OF DIABETIC ANDPREECLAMPTIC MOTHERS IN EARLY INFANCYObjective: To evaluate the iron status in the infants of diabetic andpreeclamptic mothers at birth , at two and four months of age and to revisethe timing of the prophylactic iron treatment.Patients and methods: The study comprised infants of preeclamptic,diabetic and healthy mothers who were born in Dokuz Eylül UniversityHospital and Ministry of Health Ege Maternity Hospital between December2005 and December 2006.Complete blood count and iron stores (iron, iron binding capacity,ferritin) of the infants were examined at birth in cord blood or in venousblood in the first 24 hours, and at two months and four months of age in thevenous blood . Newborns who were 35 weeks or older were included in thestudy. The exclusion criteria included infants with perinatal infection,chromosomal anomaly, congenital metabolic disease, congenitalmalformation, early membrane rupture lasting more than 24 hours, 5- minApgar score lower than 7 and the infants who received erythrocytetransfusion or phlebotomy. In the follow up period, the hospitalized infantsand the infants who had a resistant infection, a hematologic disease that isnot related to iron and of whom the mothers had iron treatment in thepostnatal period were excluded.Data including sex, physical examination at birth and at two and fourmonths of age, body weight, labarotory results, nutritional status of theinfants and the age, number of gravidity, occupatinal status, healthcondition, if used any medication and the family history of the motherswere recorded in detail. The health centers where the birth and follow-upwere undertaken and the complete blood count values of the mothers atbirth were also recorded. All the cases were followed by the samephysician.Results: Being totally 63 infants;13 preeclamptic, 20 diabetic and 30healthy mother infants who were born in Dokuz Eylül University Hospitaland Ministry of Health Ege Maternity Hospital met the full criteria andenrolled in the study. The 27 cases (43%) were female and 36 cases (57%)9were male. 14 infants (70%) from the diabetic group , eight infants (61,5%)from the preeclampsia group and 13 infants (43,3%) from the control groupwere seen at two and four months of age.Comparing between three groups, there was a statistically significantdifference between the values of iron at birth, MCV at two months of age,total iron bindind capacity (TIBC) at four months of age and motherhematocrit and Hb.Applying Mann- Whitney U test with the Bonferroni correction, it?sseen that the differences in the value of iron resulted from the preeclampsiaand control group; in the value of MCV resulted from the diabetic andcontrol group; in the value of the TIBC resulted from the preeclampsia andcontrol group and the difference in the value of the mother MCV resultedfrom the preeclampsia and control group.Compared with the control group, in the preeclampsia group; thevalues of Hb, MCV at birth and TIBC at four months of age weresignificantly higher while iron value of the infant at birth and the Hb,hematocrit and MCV values of the mothers were significantly lower. Alsowhen compared with the diabetic group, in the preeclampsia group, the Hband Htc values at birth were higher while the platelet count at birth , MCVvalue at two months of age and ferritin value at four months of age weresignificantly lower .Comparing the diabetic and the control group, the MCV value at twomonths of age was significantly higher in the diabetic group, while theMCV value of the mother was significantly lower.In the diabetic group one case at birth (5%), in the preeclampsia grouptwo cases at four months of age were included in phase one iron deficiency.There were no cases meeting the full criteria of phase two and three irondeficiency.Conclusion: In the infants of the preeclamptic mothers the serum ironlevels decrease during the follow-up and iron deficiency may occur duringearly infancy. Consistent with the World Health Organizationrecommendations, it?s appropriate to start prophylactic iron treatment toterms at four months.Key words: Infant of diabetic-preeclamptic mother, iron store, ironprophylaxis10