Effects Of Preventive Iron Supplement On Iron Status And Auditory Brainstem Response In Premature Infants

Background:Iron deficiency and iron deficiency anemia remain a worldwide concern.Iron is the most common single nutritional deficiency among children in developing countries.Iron deficiency anemia(IDA)is still a common cause of anemia in infants and children in industrialized countries,despite a significant drop in incidence.More important than anemia itself,however,common ID without anemia can also have adverse effects on long-term neural development and behavior,some of which can be irreversible.Low iron reserves at birth and rapid catch-up growth after birth lead to higher rate s of iron deficiency in premature infants.During the critical period of brain development,early iron deficiency affects the central nervous system and eventually leads to changes in neural development and cognitive behavior by affecting the formation of myelination,brain nerve metabolism,and the transmission of neurotransmitters such as dopamine.It is of great practical significance to provide routine iron supplement for premature infants,to reduce the incidence of iron deficiency and iron deficiency anemia in premature infants,to help the recovery of brain function,to improve neurological development and quality of life in premature infants,and to improve long-term prognosis.Objective:To explore the preventive effect of iron supplementation on iron deficiency and iron deficiency anemia in premature infants and to minimize the effect of iron deficiency on central nervous system myelination of premature infants.Methods:The study selected 244 premature infants who were delivered in Women’s Hospital School of Medicine Zhejiang University from April 2016 to June 2018,and were followed up with a card in our outpatient department of high-risk infants.Participating in the project study,blood routine,serum ferritin,C-reactive protein(CRP)were tested at the physiological age of 3 months,and the detection of brainstem auditory evoked potential(ABR)was completed at the correction age of 3 months.To clarify the preventive and therapeutic effects of iron supplementation on iron deficiency or iron deficiency anemia.Using regression analysis,ID was associated with birth weight,feeding patterns,growth rates,and anemia at birth.In addition,prophylactic iron supplementation after birth improved ABR in premature infants in the anemia group after birth.Analysis of the effect of iron deficiency on ABR after birth by correcting 3 months of iron status.Results:Routine iron prophylactic supplementation in premature infants can reduce the incidence of iron deficiency and iron deficiency anemia after birth.Moreover,the ABR test results of premature infants with anemia after birth were compared with those without anemia after birth.After the preventive iron supplementation,there was no statistical difference between the Ⅰ,Ⅲ and Ⅴ wave latency of ABR at the 3-month age and the peak wave interval of ⅰ-ⅲ,ⅲ-ⅴ and ⅰ-ⅴ(all P>0.05).According to the results of physiological 3-month blood test,the three months ABR Ⅲ and Ⅴ wave incubation period(P<0.001,P<0.001)and ⅰ-ⅲ and ⅰ-ⅴ peak interval of the ID group were significantly longer than those of IS premature infants(P<0.007,P<0.016),and there was no statistical difference between the two groups(P=0.408).Conclusions:Early prophylactic iron supplement can reduce the prevalence of iron deficiency and iron deficiency anemia in premature infants and reduce the effect of iron deficiency on central nervous system myelination in premature infants.