TY - JOUR
T1 - Iron supplementation and the risk of bronchopulmonary dysplasia in extremely low gestational age newborns
AU - Independent Medical Monitor
AU - PENUT Trial Consortium
AU - PENUT Co-Investigators
AU - PENUT Research Coordinators
AU - University of Washington Data Coordinating Center
AU - PENUT Executive Committee
AU - Follow Up Committee
AU - Garcia, Melissa R.
AU - Comstock, Bryan A.
AU - Patel, Ravi M.
AU - Tolia, Veeral N.
AU - Josephson, Cassandra D.
AU - Georgieff, Michael K.
AU - Rao, Raghavendra
AU - Monsell, Sarah E.
AU - Juul, Sandra E.
AU - Ahmad, Kaashif A.
AU - Mayock, Dennis E.
AU - Wadhawan, Rajan
AU - Courtney, Sherry E.
AU - Robinson, Tonya
AU - Bendel-Stenzel, Ellen
AU - Baserga, Mariana
AU - LaGamma, Edmund F.
AU - Downey, L. Corbin
AU - Fahim, Nancy
AU - Lampland, Andrea
AU - Frantz, Ivan D.
AU - Khan, Janine
AU - Weiss, Michael
AU - Gilmore, Maureen M.
AU - Ohls, Robin K.
AU - Lowe, Jean
AU - Srinivasan, Nishant
AU - Perez, Jorge E.
AU - McKay, Victor
AU - Thomas, Billy
AU - Elhassan, Nahed
AU - Mulkey, Sarah
AU - Vijayamadhavan, Vivek K.
AU - Mulrooney, Neil
AU - Yoder, Bradley
AU - Kase, Jordan S.
AU - Check, Jennifer
AU - Gogcu, Semsa
AU - Osterholm, Erin
AU - George, Thomas
AU - Georgieff, Michael
AU - Martin, Camilia R.
AU - O’Reilly, Deirdre
AU - deRegnier, Raye Ann
AU - Porta, Nicolas
AU - Bazacliu, Catalina
AU - Northington, Frances
AU - Valdez, Raul Chavez
AU - Richter, Tyler
AU - Wassenaar, Jenna
N1 - Funding Information:
This work was funded by NINDS U01NS077955 and U01NS077953.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
PY - 2022/6/20
Y1 - 2022/6/20
N2 - BACKGROUND: The aim of this study was to determine the relationship between iron exposure and the development of bronchopulmonary dysplasia (BPD).METHODS: A secondary analysis of the PENUT Trial dataset was conducted. The primary outcome was BPD at 36 weeks gestational age and primary exposures of interest were cumulative iron exposures in the first 28 days and through 36 weeks' gestation. Descriptive statistics were calculated for study cohort characteristics with analysis adjusted for the factors used to stratify randomization.RESULTS: Of the 941 patients, 821 (87.2%) survived to BPD evaluation at 36 weeks, with 332 (40.4%) diagnosed with BPD. The median cohort gestational age was 26 weeks and birth weight 810 g. In the first 28 days, 76% of infants received enteral iron and 55% parenteral iron. The median supplemental cumulative enteral and parenteral iron intakes at 28 days were 58.5 and 3.1 mg/kg, respectively, and through 36 weeks' 235.8 and 3.56 mg/kg, respectively. We found lower volume of red blood cell transfusions in the first 28 days after birth and higher enteral iron exposure in the first 28 days after birth to be associated with lower rates of BPD.CONCLUSIONS: We find no support for an increased risk of BPD with iron supplementation.TRIAL REGISTRATION NUMBER: NCT01378273. https://clinicaltrials.gov/ct2/show/NCT01378273 IMPACT: Prior studies and biologic plausibility raise the possibility that iron administration could contribute to the pathophysiology of oxidant-induced lung injury and thus bronchopulmonary dysplasia in preterm infants. For 24-27-week premature infants, this study finds no association between total cumulative enteral iron supplementation at either 28-day or 36-week postmenstrual age and the risk for developing bronchopulmonary dysplasia.
AB - BACKGROUND: The aim of this study was to determine the relationship between iron exposure and the development of bronchopulmonary dysplasia (BPD).METHODS: A secondary analysis of the PENUT Trial dataset was conducted. The primary outcome was BPD at 36 weeks gestational age and primary exposures of interest were cumulative iron exposures in the first 28 days and through 36 weeks' gestation. Descriptive statistics were calculated for study cohort characteristics with analysis adjusted for the factors used to stratify randomization.RESULTS: Of the 941 patients, 821 (87.2%) survived to BPD evaluation at 36 weeks, with 332 (40.4%) diagnosed with BPD. The median cohort gestational age was 26 weeks and birth weight 810 g. In the first 28 days, 76% of infants received enteral iron and 55% parenteral iron. The median supplemental cumulative enteral and parenteral iron intakes at 28 days were 58.5 and 3.1 mg/kg, respectively, and through 36 weeks' 235.8 and 3.56 mg/kg, respectively. We found lower volume of red blood cell transfusions in the first 28 days after birth and higher enteral iron exposure in the first 28 days after birth to be associated with lower rates of BPD.CONCLUSIONS: We find no support for an increased risk of BPD with iron supplementation.TRIAL REGISTRATION NUMBER: NCT01378273. https://clinicaltrials.gov/ct2/show/NCT01378273 IMPACT: Prior studies and biologic plausibility raise the possibility that iron administration could contribute to the pathophysiology of oxidant-induced lung injury and thus bronchopulmonary dysplasia in preterm infants. For 24-27-week premature infants, this study finds no association between total cumulative enteral iron supplementation at either 28-day or 36-week postmenstrual age and the risk for developing bronchopulmonary dysplasia.
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U2 - 10.1038/s41390-022-02160-2
DO - 10.1038/s41390-022-02160-2
M3 - Article
C2 - 35725917
SN - 0031-3998
JO - Pediatric Research
JF - Pediatric Research
ER -