文本框: Regulation of Iron Metabolism in the Fetus and Newborn Infant Terry RJ Lappin, Henry L Halliday. Departments of Haematology and Child Health, Queen's University, Belfast and Royal Group of Hospitals,Belfast, UK Iron status is difficult to assess during the neonatal period. Rapid red cell turnover in the first few weeks of life leads to increased serum iron, transferrin saturation and circulating ferritin concentrations,irrespective of iron availability. In preterm babies this rapid red cell turnover together with inadequate erythropoiesis leads to early anaemia of prematurity. Iron stores are also depleted but the relative contribution of iron deficiency to this anaemia is unclear. Measurement of serum soluble transferrin receptors (STfR) provides a new method of assessing iron status and the ratio of STfR to the log of the serum ferritin concentration (TR-F index) is a useful measure of iron status that reflects the requirement for iron in relation to available iron. We have determined the effects of maternal smoking, iron depletion and diabetes on the iron status of term babies using STfR and the TfR-F index in cord blood. Smoking is associated with increased fetal iron requirements for erythropoiesis. Maternal iron depletion is associated with reduced fetal iron stores but no change in free iron availability. Infants of diabetic mothers (IDMs) develop in a hyperglycaemic environment and the switch from γ-globin to β-globin is delayed. In a preliminary study ferritin concentration was significantly lower in IDMs than in the infants of non-diabetic mothers (54.7ng/ml vs 160.7 ng/ml, p<0.001) whereas the TfR/log ferritin values were significantly higher in the DM group (19.2 vs7.73, p<0.001). Hence iron metabolism is perturbed in the infants of mothers who smoke or who suffer from iron depletion or diabetes.