目的 分析小剂量补铁预防早产儿贫血的临床疗效,为儿童保健工作中合理使用铁剂预防早产儿贫血提供参考依据。方法 选取南京市妇幼保健院高危儿随访中心进行随访的早产儿68例作为干预组,根据喂养方式给予小剂量铁剂口服,母乳喂养者铁元素每日2 mg/kg,人工喂养者每日铁元素1 mg/kg,混合喂养者按配方奶占总奶量的比例:<50%,每日铁元素2 mg/kg;≥50%,每日铁元素1.5 mg/kg。同期选择未参加高危儿随访并且未补充铁剂的72名早产儿为对照组,两组早产儿均在生后6月龄检测血常规。结果 干预组的血红蛋白平均值明显高于对照组 (P<0.05);干预组贫血的发生率较对照组显著降低(P<0.05);干预组不同喂养方式之间比较贫血的发生率无显著差别。结论 基于喂养方式的小剂量补铁,能有效增加早产儿体内铁储备,降低早产儿贫血的发生率。
Abstract
Objective To study the clinical efficacy of low dose iron supplementation on prevention of premature infant anemia. Methods A total of 68 premature infants were randomly selected as research objects from the follow-up center of high-risk infants in Nanjing Maternal and Child Health Hospital. The research group was treated with low dose of iron according to the feeding pattern of the premature infants. The breast-fed infants were supplied with oral elemental iron 2 mg/kg per day and the artificial feeding infants were supplied with oral elemental iron 1 mg/kg per day. The iron dosage of mixed-fed infants were chosen according to the proportion of formula of total milk amount(<50%,2 mg/kg;≥50%,1.5 mg/kg). Over the same period,another 72 premature infants who did not participate in follow up were chosen as control group without oral supplement of iron. The routine blood was tested when the premature infants were six months old. Results The average hemoglobin level of intervention group was higher than that of the control group (P<0.05) and the incidence of anemia in intervention group was significantly lower than that in control group (P<0.05). In addition,no significant differences on the incidence of anemia were found among infants with different feeding-pattern in intervention group. Conclusions Low dose iron supplementation based on feeding patterns can effectively improve the levels of iron storage and reduce the prevalence of anemia in premature infants.
关键词
早产儿 /
铁 /
贫血 /
预防
Key words
premature infants /
iron /
anemia /
prevention
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参考文献
[1] Rao R,Georgieff MK.Iron in fetal and neonatal nutrition [J].Semin Fetal Neonatal Med,2007,12(1):54-63.
[2] Geng F,Mai X,Zhan J,et al.Impact of fetal-neonatal iron deficiency on recognition memory at 2 months of age[J].Pediatr,2015,167(6):1226-1232.
[3] Shafir T,Angulo-Barroso R,Su J,et al.Iron deficiency anemia in infancy and reach and grasp development [J].Infant Behav Dev,2009,32(4):366-375.
[4] MacQueen BC,Christensen RD,Ward DM,et al.The iron status at birth of neonates with risk factors for developing iron deficiency: a pilot study[J].J Perinatol,2017,37(4):436-440.
[5] WHO global database on anemia.World wide prevalence of anemia 1993-2005.[R/OL].[2010-05-09.]http:// whqlibdoc.Who.int/publications/2008/9789241596657_eng.pdf.
[6] Ferri C,Procianoy RS,Silveira RC.Prevalence and risk factors for iron-deficiency anemia in very-low-birth-weight preterm infants at 1 year of corrected age [J].J Trop Pediatr,2014,60(1):53-60.
[7] Vucic V,Berti C,Vollhardt C,et al.Effect of iron intervention on growth during gestation,infancy,childhood,and adolescence: a systematic review with meta-analysis [J].Nutr Rev,2013,71(6):386-401.
[8] Fretham SJ,Carlson ES,Georgieff MK.The role of iron in learning and memory[J].Adv Nutr,2011,2(2):112-121.
[9] 邵洁.胎婴儿期合理铁营养与儿童大脑发育[J].中国实用儿科杂志,2015,30(12):892-896.
[10] 中华医学会儿科学分会儿童保健学组,《中华儿科杂志》编辑委员会.儿童微量营养素缺乏防治建议[J].中华儿科杂志,2010,48(7): 502-509.
[11] Long H,Yi JM,Hu PL,et al.Benefits of iron supplementation for low birth weight infants: a systematic review[J].BMC Pediatr,2012,12:99.
[12] Jin HX,Wang RS,Chen SJ,et al.Early and late Iron supplementation for low birth weight infants: a meta-analysis[J].Ital J Pediatr,2015,41:16.
[13] 王爱萍,赵巧荣.早产儿缺铁性贫血的预防与分析[J].中国妇幼卫生杂志,2014,5 (3):65-67.