[Iron requirements during the first 6 months of life]. / Recommandations pour les apports en fer pendant les six premiers mois de vie.

Because of the postnatal redistribution of the iron store, the term infant born after an uneventful pregnancy virtually needs no iron during its first 6 months of life. On the other hand, several factors, such as duration of gestation, gender, mother's iron status, alteration of the iron placental transfer, significantly influence the iron store at birth. Because of their reduced body store at birth and their higher demand during catch-up growth, low birth weight infants should receive an iron supplement, which should be started earlier and given at a higher dose in the more premature infants. This preventive strategy can be given as enteral supplement, preterm formula, or enriched breast milk. Finally, because of its benefits on neonatal morbidity and iron status, delayed umbilical cord clamping is recommended for preterm infants.

[Insulin treatment of gestational diabetes and respiratory outcome in late-preterm and term babies]. / Diabète gestationnel traité par insuline et risque de détresse respiratoire sévère chez le nouveau-né de plus de 34 semaines d'aménorrhée.

While the incidence of diabetes mellitus (DM) during pregnancy has been steadily increasing in recent years, the link between gestational DM and respiratory outcome in neonates has not been firmly established. To address this gap in understanding, we asked whether DM status and its treatment during pregnancy influence risk of neonatal respiratory distress. We conducted retrospective analysis of a large cohort to determine the relationship between maternal DM status (non-DM, insulin-treated DM [DTI], and non-insulin-treated DM [DTR]) and respiratory distress in term and near-term singletons, born at Robert-Debré Hospital over a 7-year period. Of 18,095 singletons delivered at 34 weeks of gestation or later, 412 (2.3%) were admitted to the NICU for respiratory distress within the first hours of life. The incidence of NICU admissions due to respiratory distress was 2.2% in the non-DM group, 2.1% in the DTR group, and 5.7% in the DTI group. Insulin treatment of DM, together with several other perinatal factors, was associated with an increased risk for severe respiratory distress. In a multivariate model, we found that DTI, but not DTR, was a risk factor independent of gestational age and cesarean section, with an IRR of 1.44 (95% CI, 1.00-2.08). The data indicate that newborns of mothers with DM treated with diet are not at risk for severe respiratory distress. Conversely, newborns of mothers with DM treated with insulin are associated with elevated risk for severe respiratory disease and should therefore be closely monitored.