Enteral Iron Supplementation in Infants Born Extremely Preterm and its Positive Correlation with Neurodevelopment; Post Hoc Analysis of the Preterm Erythropoietin Neuroprotection Trial Randomized Controlled Trial.
Adult
Enteral Nutrition
Erythropoietin
/ administration & dosage
Female
Humans
Infant
Infant, Extremely Premature
/ growth & development
Infant, Newborn
Iron
/ administration & dosage
Male
Neurodevelopmental Disorders
/ prevention & control
Neuroprotection
/ drug effects
Pregnancy
Prospective Studies
Epo
erythropoietin
extremely low gestational age neonate
extremely preterm neonate
iron
neonate
neurodevelopment
neurodevelopmental outcomes
Journal
The Journal of pediatrics
ISSN: 1097-6833
Titre abrégé: J Pediatr
Pays: United States
ID NLM: 0375410
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
19
04
2021
revised:
18
06
2021
accepted:
02
07
2021
pubmed:
30
7
2021
medline:
24
11
2021
entrez:
29
7
2021
Statut:
ppublish
Résumé
To test whether an increased iron dose is associated with improved neurodevelopment as assessed by the Bayley Scales of Infant Development, third edition (BSID-III) among infants enrolled in the Preterm Erythropoietin (Epo) Neuroprotection Trial (PENUT). This is a post hoc analysis of a randomized trial that enrolled infants born at 24-28 completed weeks of gestation. All infants in PENUT who were assessed with BSID-III at 2 years were included in this study. The associations between enteral iron dose at 60 and 90 days and BSID-III component scores were evaluated using generalized estimating equations models adjusted for potential confounders. In total, 692 infants were analyzed (355 placebo, 337 Epo). Enteral iron supplementation ranged from 0 to 14.7 mg/kg/d (IQR 2.1-5.8 mg/kg/d) at day 60, with a mean of 3.6 mg/kg/d in infants treated with placebo and 4.8 mg/kg/d in infants treated with Epo. A significant positive association was seen between BSID-III cognitive scores and iron dose at 60 days, with an effect size of 0.77 BSID points per 50 mg/kg increase in cumulative iron dose (P = .03). Greater iron doses were associated with greater motor and language scores but did not reach statistical significance. Results at 90 days were not significant. The effect size in the infants treated with Epo compared with placebo was consistently greater. A positive association was seen between iron dose at 60 days and cognitive outcomes. Our results suggest that increased iron supplementation in infants born preterm, at the doses administered in the PENUT Trial, may have positive neurodevelopmental effects, particularly in infants treated with Epo. Clinicaltrials.gov: NCT01378273.
Identifiants
pubmed: 34324880
pii: S0022-3476(21)00686-7
doi: 10.1016/j.jpeds.2021.07.019
pmc: PMC8629150
mid: NIHMS1728193
pii:
doi:
Substances chimiques
EPO protein, human
0
Erythropoietin
11096-26-7
Iron
E1UOL152H7
Banques de données
ClinicalTrials.gov
['NCT01378273']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
102-109.e8Subventions
Organisme : NINDS NIH HHS
ID : U01 NS077953
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS077955
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
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