Non-anaemic iron deficiency identified by ZPP test in extremely premature infants: prevalence, dietary risk factors, and association with neurodevelopmental problems

Introduction: The aims of this study were to determine, in a cohort of extremely premature infants, the prevalence of iron deficiency identified by zinc protoporphyrin/heme ratio (ZPP) testing, and its association with neurodevelopmental problems and dietary risk factors for iron deficiency. Methods...

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Published in:	Early human development Vol. 70; no. 1; pp. 73 - 83
Main Authors:	O'Keeffe, M.J, O'Callaghan, M.J, Cowley, D, Tudehope, D.I, Gray, P, Burns, Y, Mohay, H
Format:	Journal Article
Language:	English
Published:	Lausanne Elsevier Ireland Ltd 01-12-2002 New York,NY Elsevier Amsterdam
Subjects:	Anemias. Hemoglobinopathies Behaviour Biological and medical sciences Child, Preschool Development Developmental Disabilities - epidemiology Developmental Disabilities - etiology Developmental Disabilities - physiopathology Diet Diseases of red blood cells Extremely low birth weight infants Gestational Age Hematologic and hematopoietic diseases Hematologic Tests Heme - analysis Humans Infant Infant, Newborn Infant, Premature - blood Infant, Very Low Birth Weight - blood Iron - deficiency Iron, Dietary Medical sciences Prospective Studies Protoporphyrins - blood Queensland - epidemiology Risk Factors Surveys and Questionnaires Zinc protoporphyrin Queensland Development Behaviour Diet Extremely low birth weight infants Iron deficiency Zinc protoporphyrin Human Premature Prevalence Iron deficiency anemia Central nervous system Infant Hemopathy Extremely low birthweight Feeding Protoporphyrin Risk factor Heme Behavior Sideropenia
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Summary:	Introduction: The aims of this study were to determine, in a cohort of extremely premature infants, the prevalence of iron deficiency identified by zinc protoporphyrin/heme ratio (ZPP) testing, and its association with neurodevelopmental problems and dietary risk factors for iron deficiency. Methods: Infants of less than 29 weeks' gestation or less than 1000 g birth weight were studied prospectively at a multidisciplinary follow-up clinic. Assessments were made at a corrected age of either 12 months ( n=72) or 2 years ( n=69). Physical examination, Griffiths Developmental Scale, and neurosensory-motor assessment were administered, information on diet and behaviour was obtained by questionnaire, and a fingerprick ZPP ratio was performed to identify iron deficiency. Results: 18.4% of infants had positive ZPP tests. There was no significant association between a positive ZPP test result and dietary risk factors, or symptoms of lethargy, irritability or poor attention. In children without cerebral palsy, there was no difference on Griffiths scores or neurosensory-motor assessment between ZPP-positive and ZPP-negative groups. The diagnosis of cerebral palsy ( n=12) was significantly associated with both a positive ZPP test and a lower Griffiths general quotient (GQ) score. Conclusions: Iron deficiency occurs commonly in extremely low birth weight (ELBW) children in early childhood, and is not predicted by dietary risk factors. The prevalence of iron deficiency is increased in ELBW children with cerebral palsy. Non-anaemic iron deficiency (NAID) does not impair development or significantly affect behaviour of ELBW subjects who do not have cerebral palsy.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0378-3782 1872-6232
DOI:	10.1016/S0378-3782(02)00072-5