Impact of the multiple births on the postnatal iron indices in premature infants

PURPOSE: To investigate the impact of the multiple births on the iron metabolism indices in premature infants. MATERIAL AND METHODS: 102 premature infants, born before 33rd gestational week (GW), are investigated, divided in two groups: control group 1 - singletons (n 69), and case group 2 - twins (n 33). The serum levels of ferritin (Ferr), transferrin (Tf), soluble transferrin receptors (sTfR), iron (Fe), total iron binding capacity (TIBC) and transferrin saturation (SatTf) are examined from the birth to the term. RESULTS: The singletons are complicated more frequently by nosocomial infections also they require more often early haemotransfusions. Their initial levels of Ferr are higher; but sTfR - lower, especially in 36th week corrected age (WCA). Levels of Tf of the twins are elevated sharply after 33rd WCA, but to term are above upper limit of norm. The sTfR levels are higher and above normal value through whole observational period. Fe-curve is upward, but TIBC is on the lower limit through that period. Calculating SatTf, we established that twins are iron deprived at birth, but 1/3 of singletons are iron overloaded. Despite neonatal complications, 80% from singletons are with normal SatTf at term, but iron overload in twins are twice higher (42 vs. 20%). CONCLUSION: The multiple births are a risk factor concerning iron homeostasis in the infants, born before 33rd GW.