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Serum ferritin values in neonates <29 weeks’ gestation are highly variable and do not correlate with reticulocyte hemoglobin content
Bahr, T. M., Tan, S., Smith, E., Beauman, S. S., Schibler, K. R., Grisby, C. A., Lowe, J. R., Bell, E. F., Laptook, A. R., Shankaran, S., Carlton, D. P., Rau, C., Baserga, M. C., Flibotte, J., Zaterka-Baxter, K., Walsh, M. C., Das, A., Christensen, R. D., Ohls, R. K., & Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2023). Serum ferritin values in neonates <29 weeks’ gestation are highly variable and do not correlate with reticulocyte hemoglobin content. Journal of Perinatology, 43(11), 1368-1373. https://doi.org/10.1038/s41372-023-01751-z
OBJECTIVES: To compare serum ferritin and RET-He values among extremely low gestational age neonates ELGANs with other markers of iron-deficient erythropoiesis.
STUDY DESIGN: This is a secondary analysis of the NICHD Darbepoetin Trial. Study data from placebo recipients who had a serum ferritin, a RET-He, and a mean corpuscular volume (MCV) measurement within a 24-hour period were analyzed for correlation.
RESULTS: Mixed linear regression models showed no association between ferritin and RET-He at both early (β = 0.0016, p = 0.40) and late (β = -0.0001, p = 0.96) time points. Positive associations were observed between RET-He and MCV at baseline, early, and late time points (p < 0.01, =0.01, <0.001, respectively), while ferritin was not associated with MCV at any time point.
CONCLUSIONS: Our study shows that RET-He is better correlated with MCV as a marker of iron-limited erythropoiesis than ferritin. The results suggest that ferritin is limited as a marker of iron sufficiency in premature infants.
STUDY IDENTIFICATION: FDA IND Number 100138; ClinicalTrials.gov number NCT03169881; NRN ID number NICHD-NRN-0058 (Darbe).
