Latent Iron Deficiency in Neonates With and Without Risk Factors for Poor In-Utero Iron Status.

OBJECTIVE: To determine the proportion of latent iron deficiency (LID) in neonates delivered at more than 34 weeks gestation with and without risk factors for in-utero iron deficiency. METHODS: This observational study enrolled neonates delivered at more than 34 weeks gestation. Maternal antenatal history, risk factors for placental insufficiency, hemoglobin, and serum ferritin levels were collected upon admission for confinement. Neonates were categorized based on the presence of risk factors, and further categorized based on ferritin concentrations (cord blood or venous blood < 72 hours) into those with ferritin > 75 ng/mL (normal iron status) and those with ferritin between 11-75 ng/mL (LID). RESULTS: Among 559 neonates, 295 had underlying risk factors for poor in-utero iron status. Overall, 45 (9.8%) neonates had LID with an incidence of 10.5% in those with risk factors and 5.3% in those without risk factors [Odds Ratio (95% CI) 2.09 (1.08, 4.03); P value = 0.02]. Maternal anemia and gestational hypertension were found to be significant independent risk factors for LID. CONCLUSION: This study highlights the higher LID in at-risk neonates, emphasizing the need for targeted interventions to prevent iron deficiency.

Effects of latent iron deficiency on auditory neural maturation during early infancy in infants above 35 weeks' gestation.

BACKGROUND: Latent iron deficiency (LID) at birth is associated with prolonged latencies in auditory brainstem response (ABR), a surrogate for neural maturation. This study aimed to compare wave and inter-peak latencies of ABR at birth and at 4-6 months of age in infants ≥35 weeks of gestation with normal iron status (NIS) and LID. METHODS: Neonates born at ≥35 weeks were screened. Cord ferritin value ≤ 75 ng/mL and >75 ng/mL were classified as LID and NIS, respectively. ABR was performed within 48 h of birth. The absolute latencies of waves I, III, and V, and inter-peak latencies I-III, III-V, and I-V were computed. Infants were reassessed at 4-6 months of age for hemoglobin, serum ferritin levels, and ABR latencies. RESULTS: In total, 160 neonates were enrolled. The mean (SD) birth weight and gestational age of the study population were 2843 (384) g and 38.3 (1.1) weeks, respectively. Approximately 122 infants completed follow-up until 4-6 months of age: 37 in the LID group and 85 in the NIS group. Overall, the wave and interpeak latencies in both groups at birth were comparable. At 4-6 months, the absolute latencies of waves I, III, and V, and inter-peak latencies I-III, III-V, and I-V were decreased and were comparable in both groups. Among small-for-gestational-age neonates, inter-peak latencies in I-III and I-V at birth were significantly longer in the LID group than in the NIS group. Nine (24.3%) infants in the LID group and none in the NIS group were iron-deficient at 4-6 months of age. CONCLUSION: There was no difference in wave or inter-peak latencies at birth and at 4-6 months of age in neonates aged ≥35 weeks with or without LID. However, infants with LID at birth have a significant risk of iron deficiency at 4-6 months of age. CTRI/2017/08/009379 (www.ctri.nic.in).

A descriptive study of behavioral problems in schoolgoing children.

BACKGROUND: Behavioral problems among schoolgoing children are of significant concern to teachers and parents. These are known to have both immediate and long-term unfavorable consequences. Despite the high prevalence, studies on psychiatric morbidity among school children are lacking in our country. MATERIALS AND METHODS: Five hundred children aged 6-18 years were randomly selected from a government school in Kanpur, Uttar Pradesh, and assessed for cognitive, emotional, or behavioral problems using standardized tools. RESULTS: About 22.7% of children showed behavioral, cognitive, or emotional problems. Additional screening and evaluation tools pointed toward a higher prevalence of externalizing symptoms among boys than girls. CONCLUSION: The study highlights the importance of regular screening of school children for preventive as well as timely remedial measures.