The influence of gestational age, size for dates, and prenatal steroids on cord transferrin levels in newborn infants

Serum transferrin levels assess protein status in older children and adults. To generate standards for its use in newborn infants, we measured umbilical cord serum transferrin levels in 161 appropriate (AGA), 25 large (LGA) and 16 small (SGA) for gestational age infants between 25 and 43 weeks’ gestation. We also assessed the effects of intrauterine growth, exposure to prenatal steroids, and presence of pulmonary maturity on neonatal transferrin levels. Cord transferrin levels in AGA infants were significantly correlated with increasing gestational age (r = 0.60; p < 0.001). Infants born before 37 weeks’ gestation had significantly lower transferrin levels, when compared with those born at term (p < 0.001). LGA infants had significantly higher levels than age-matched AGA infants (253 ± 75 vs. 214 ± 53 mg/dl; p < 0.025). Despite significantly lower mean birth weights (p < 0.001), SGA infants also had significantly higher levels than gestational age-matched AGA controls (227 ± 63 vs. 167 ± 40 mg/dl; p < 0.005). For infants <35 weeks’ gestation, neither the 20 preterm infants with exposure to prenatal steroids (maternal betamethasone), nor the 26 infants with pulmonary maturity had significantly elevated transferrin levels, when compared with gestational age-matched control infants. Newborn transferrin levels correlate well with gestational age and are significantly affected by size for dates, but not by a brief course of prenatal steroids or by pulmonary maturity.