Study of the effect of maternal iron depletion on neonatal iron metabolism

Maternal nutritional and hormonal state from as early as the first days after fertilization can influence the growth rate of the fetus and also the length of gestation. was firstly; to study iron indices [serum iron, ferritin, and soluble transferrin receptors "STFR"] in neonates, and their relation with gestational age, birth weight and gender. Also, to assess the value of utilization of STFR and STFR/ Log ferritin index to evaluate the effects of maternal anemia, iron status, and iron supplementation, on neonatal iron indices at birth. Serum Iron, ferritin, STFR, and haemoglobin [Hb] concentration were measured and STFR-Log ferritin index was calculated in 40 cord serum [20 preterm "PT", and 20 full term "FT" neonates], and from their maternal serum. Seventeen mothers were anemic "Hb < 10 gm%", [5 mothers of FT, and 12 of PT babies]. Twelve mothers had depleted iron stores "serum ferritin <10 micro g/1" [4mothers of FT, and 8 PT babies]. Non of FT babies had anemia, while 9 PT had anemia, Fullterm neonates and neonates weighing >/= 2.5 Kg had significantly higher cord blood Hb, serum iron and ferritin, compared to PT neonates and neonates weighing < 2.5 Kg. Neonates weighing >/- 2.5 Kg had significantly lower STFR/Log ferritin, compared to neonates weighing < 2.5 Kg. No difference in iron indices was found between male and female neonates, also, between neonates delivered to mothers with iron supplementation during pregnancy and those without, and between neonates delivered vaginally and those by cesarean section. There was no difference in iron indices between neonates with either maternal anemia or depleted iron stores, and those with normal maternal indices. There is no relation between maternal iron status and neonatal iron indices, except for serum ferritin. Cord serum ferritin correlates positively with maternal ferritin. So, cord serum ferritin, but neither STFR nor STFR/Log ferritin, is a good indicator of neonatal iron stores at birth. Maternal iron depletion is not associated with neonatal anemia. The fetus has normal indices on the expense of his mother's iron stores. So, maternalsupplementation with iron during pregnancy is a must

Early onset neonatal sepsis, rule out viral infection

This cross-sectional prospective study was an attempt to define the frequency of viral infections in early onset neonatal sepsis. It was conducted on 260 septic neonates with different diagnoses who had been admitted to Neonatal Intensive Care Unit, affiliated to Obstetric and Gynecology Department, Ain Shams University Hospitals throughout one year from November 2001 to October 2002. Their mean gestational age was 35.9 +/- 3.7 weeks, their mean birth weight was 2.4 +/- 1.08 kg and their mean postnatal age was 12.35 +/- 10.34 days. They included 148 males and 112 females. The results of this study revealed that 49 out of 260 septic neonates [19%] were diagnosed as virus infected using different cell cultures. Seven viruses were identified by indirect fluorescent antibody tests [IFA] which were in order of frequency; cytomegalovirus [5%], respiratory syncytial virus [3.4%], Echo-11 [3.1%], Echo-14 [2.7%], Coxsackie B5 [2.7%], mumps [1.2%] and parainfluenza type 3 [0.8%]. Most of virus infected cases presented with low Apgar score, low or very low birth weight, prematurity, jaundice, peticheal rash, in addition to signs of sepsis. Meanwhile, respiratory viruses [respiratory syncytial virus, parainfluenza virus] were the major pathogens among respiratory distressed infants, enteroviruses, cytomegalovirus and mumps were implicated in neonates with multiple congenital malformations. Cytomegalovirus was the most prevalent single virus isolated. Thirteen cases out of 260 septic neonates proved to be CMV positive. 77% were congenitally acquired, while 23% were postnatally acquired. These neonates presented with various clinical presentations, the most common were prematurity [85%], very low birth weight [62%], jaundice [54%] and hepatosplenomegaly [46%], meanwhile congenital malformations were recorded in 23% of cases [microcephaly, congenital hernia and congenital cataract]. Mortality rate was 46%. It is concluded from this study that viral infection is significantly implicated in the etiopathogenesis of neonatal sepsis. So, this study should raise the awareness of the neonatologists for the diagnosis and anticipation of the potential implications of virus infection on the subsequent growth and development of the newborn infants.