A
RANDOMISED TRIAL COMPARING DAILY AND TWICE WEEKLY IRON SUPPLEMENTATION IN
VERY LOW BIRTH WEIGHT INFANTS
Mphahlele
R, Saloojee H
Chris
Hani Baragwanath Hospital and University of the Witwatersrand,
Johannesburg, South Africa
Objective:
To
establish the effectiveness of twice weekly iron supplementation compared
to daily administration in very low birth weight (VLBW) infants.
Methods:
A
randomised, controlled, non-blinded trial was conducted over a two year
period. Infants with a birth weight < 1500 g were randomised at 28 days
of age to commence oral elemental iron supplementation at a dose of
2mg/kg/dose given either daily, or twice a week, for 6 months. Haemoglobin
(Hb) and serum ferritin levels were compared at study entry, and at 10
weeks, 4 and 6 months of age. Secondary outcome measures were weight gain,
number of infections acquired and mortality.
Results:
A
total of 197 infants were enrolled; 106 in the daily group and 91 in the
twice weekly group. There was a 60% follow-up rate at 6 months. There was
no significant difference between the two groups at study entry in birth
data or outcome measures (Hb, ferritin). At 10 weeks of age, infants given
daily supplements had a higher Hb (9.10 g/dL vs. 8.49 g/dL, p=0.004).
However, this difference in Hb had disappeared by 4 months of age (10.38
g/dL vs. 10.35 g/dL, p=0.89), and Hb levels were also similar at 6 months
of age. There were no significant differences at 10 weeks, 4 months and at
6 months of life in serum ferritin levels or any of the other secondary
outcome measures. Estimated total iron intake (including other sources) was
similar in the two groups during the study period.
Conclusions:
There was no significant
difference in Hb and ferritin levels in the first six months of life
between VLBW infants supplemented either daily or twice weekly with iron.
Adopting a twice weekly regimen could greatly simplify the provision of
iron supplements to VLBW infants.