RESUMO
OBJECTIVES: To test whether iron supplementation affects hematologic, biochemical, and developmental status in term breast-fed infants. STUDY DESIGN: Term breast-fed infants (n=77) were randomly selected to receive either 7.5 mg per day of elemental iron as ferrous sulfate or placebo from 1 to 6 months of age. Investigators and families were unaware of group assignment. Complete blood count and ferritin, red cell superoxide dismutase, catalase, plasma ferric reducing antioxidant power, and zinc and copper levels were analyzed at 1, 3.5, 6, and 12 months of age. Bayley mental and psychomotor developmental indexes (MDI and PDI) and visual acuity (with the use of Teller acuity cards) were assessed from 12 to 18 months of age. Analysis performed by analysis of variance and t tests was by intention to treat. RESULTS: Iron supplementation resulted in higher hemoglobin and mean corpuscular volume at 6 months of age and significantly higher visual acuity and PDI at 13 months of age (100+/-12 vs 93+/-9 [+/-SD]). Treatment and placebo groups did not differ in anthropometric indexes, compliance, biochemical status, or demographic characteristics. CONCLUSIONS: Iron supplementation of breast-fed infants appears safe and might have beneficial hematologic and developmental effects for some infants.
Assuntos
Aleitamento Materno , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Ferro/administração & dosagem , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/prevenção & controle , Peso Corporal , Aleitamento Materno/estatística & dados numéricos , Catalase/sangue , Cognição/efeitos dos fármacos , Cobre/sangue , Método Duplo-Cego , Feminino , Ferritinas/sangue , Humanos , Lactente , Recém-Nascido , Ferro/farmacologia , Masculino , Destreza Motora/efeitos dos fármacos , Desempenho Psicomotor/efeitos dos fármacos , Superóxido Dismutase/sangue , Acuidade Visual/efeitos dos fármacos , Zinco/sangueRESUMO
OBJECTIVE: To examine circadian variation in deaths among infants < or =32 weeks' gestation admitted to Canadian neonatal intensive care units (NICU). STUDY DESIGN: We examined all infants (n=5192) between 24 and 32 weeks' gestation with complete data, who were admitted to 17 tertiary Canadian Neonatal Network NICUs from January 1996 to October 1997. Multivariable logistic regression was used to compare risk-adjusted early neonatal mortality rates (death within 7 days of NICU admission) of infants admitted during daytime (8 am to 5 pm) with infants admitted at night. RESULTS: Sixty percent (n=3131) of infants were admitted to the NICU at night. Patient risk factors significantly (P<.05) predictive of early neonatal death from multivariable logistic regression were male sex, outborn status, APGAR score <7 at 5 minutes, presence of congenital anomalies, low gestational age, and high admission Score for neonatal acute physiology, version II (SNAP-II). For inborn infants, in-house presence of a neonatal fellow or attending neonatologist at night (odds ratio, 0.6) and NICU admission at night (odds ratio, 1.6) were also predictive. CONCLUSIONS: Risk-adjusted early neonatal mortality odds was 60% higher among inborn infants < or =32 weeks' gestation admitted to NICUs at night compared with during daytime, equivalent to 29 excess deaths per 1000 infants.