OP-036 Effect of early iron supplementation on haemoglobin and iron store status in LBW babies -a randomized open label study

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Aim Deficiency of iron affects multiple organ systems, and poor neurodevelopment is the most worrisome effect. Low birth weight neonates are more likely to develop iron deficiency anemia than term counterparts. The guidelines for supplementation of iron in LBW neonates are ill-defined with varying recommendations pertaining to the intiation. Hence this study focuses on the effect of early supplementation of iron and its effect on iron store status in them. Material and Method In this randomized open label interventional tudy, 48 LBW neonates (EI group) were administered iron supplementation (at 2 weeks or when full feeds achieved), and other 48 were controls. All neonates were assessed for hemoglobin level, RBC count and iron status indicators (PCV, Serum Ferritin) at or after 6 weeks of postnatal age. Results The post-intervention values of mean haemoglobin (CASES 12.68± 1.51 g⁄dl, CONTROLS-11.38±1.03 g/dl), mean serum ferritin (CASES: 238.45 ng/ml, CONTROLS- 175.68 ng/ml), mean RBC count (CASES: 3.94±0.86 million/mm3, CONTROLS 3.16 ±0.51 million/mm3), and mean hematocrit (CASES: 33.16 ±3.75%, CONTROLS 34.04±3.45%) were noted, and the% change at 6 weeks follow up in mean Hb among CASES - 25.19%, CONTROLS 31.45% (p value:<0.01);% change in mean ferritin at follow up: CASES 15.13%, CONTROLS 32.99%(p value:<0.001);% change in mean RBC count at follow up: CASES 19.21%, CONTROLS 33.82% (p value:<0.001)] when compared to pre- inetervention values was noted. Though the haematological parameters decreased in both groups, the levels were comparatively higher in the cases compared to the controls, and iron store status was better in early iron-supplemented infants. Conclusions Iron supplementation as early as 2 weeks of postnatal age in LBW neonates improves the iron store status and reduces the incidence of iron deficiency in them.