신생아에서 철 인자와 트란스페린 수용체

Abstract

Purpose : Serum soluble transferrin receptor (sTfR) is a marker of iron deficiency and erythropoiesis. The purpose of this study is to evaluate the changes of iron parameters and sTfR in neonates by gestation; and to determine whether cord blood parameters for iron status and erythropoiesis are influenced by maternal iron deficiency or anemia.

Methods: Cord sTfR, iron and ferritin concentrations, hemoglobin (Hb), reticulocyte counts and total iron binding capacity were analyzed in 20 preterm and 60 term newborns. In term neonates, maternal iron status was classified by Hb and serum ferritin as anemic group (n=18; Hb <11 g/dl and ferritin <12 µg/l), non-anemic group (n=14; Hb ≥11 g/dl and ferritin <12 µg/l) and control (n=21, non anemic and non iron deficient).

Results : 1) Cord serum iron of preterm neonates was significantly lower than that of fullterm and the reticulocytes were significantly higher in preterm neonates. 2) The concentrations of cord serum iron were correlated positively with the gestational age, but other iron parameters and sTfR concentrations were not related to gestational age. The sTfR concentrations were correlated positively with cord blood hemoglobin. 3) Cord sTfR concentrations were significantly lower in newborns of anemic group compared with those of non-anemic group (P=0.03), or control (P=0.02).

Conclusion : Cord sTfR was influenced by maternal iron deficiency aenmia, but not by maternal iron deficiency alone. Since sTfR reflects fetal erythropoietic activity, we speculate that low sTfR in newborns of iron deficiency anemic mother could suggest decreased fetal erythropoiesis by maternal anemia caused by iron depletion.