Iron homeostasis after blood transfusion in stable preterm infants - An observational study

Jacky Herzlich, Ita Litmanovitz, Rivka Regev, Sofia Bauer, Gisela Sirota, Zvi Steiner, Shmuel Arnon*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


To evaluate the short-term effects of blood transfusion on iron status [hemoglobin, ferritin, soluble transferrin receptor (sTfR), and reticulocyte count], hepcidin, and erythropoietin in stable preterm infants. Sixty-three preterm infants treated with red blood cell transfusions (RBCTs) were included. Venous blood samples were collected before and within 24 h after each transfusion. Hemoglobin concentration increased after RBCT (7.2±1.2 g/dL vs. 13.7±2.3 g/dL, P=0.02), as well as ferritin [131 (63-110.4) ng/mL vs. 211 (125.7-299.2) ng/mL, P=0.05); reticulocyte count decreased. sTfR did not change. Hepcidin serum levels increased from 37.5 (21.3-84.7) ng/mL to 72.6 (31.3-126.2) ng/mL, (P=0.04) and erythropoietin decreased (48±19 pg/mL vs. 29±17 pg/mL, P=0.06) after RBCT. A positive linear correlation was found (R 2 =0.76, P=0.0001) between hepcidin and ferritin levels of post-minus-pre RBCT. Hepcidin levels increased significantly in preterm infants who received RBCT after 1 month of age compared to those who received RBCT at <1 month (P=0.03). No correlation was found between gestational age, weight appropriate for age, or length of blood storage and hepcidin levels. Preterm infants can control iron levels by regulating hepcidin and decreasing erythropoietin. This ability varies with postnatal age.

Original languageEnglish
Pages (from-to)919-923
Number of pages5
JournalJournal of Perinatal Medicine
Issue number8
StatePublished - 1 Oct 2016


  • Blood transfusion
  • erythropoietin
  • ferritin
  • hemoglobin
  • hepcidin


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