ROLE OF CORD FERRITIN IN PREDICTING IRON STORES IN TERM VS LATE PRETERM NEONATES - A CROSS-SECTIONAL STUDY

Abstract

INTRODUCTION Fetal iron accretion occurs mostly during the third trimester of pregnancy; therefore, late preterm infants (34 to 36 weeks) are at greater risk than term infants of being born with depleted iron reserves. Serum ferritin concentration in umbilical cord blood is a valid, non-invasive marker of neonatal iron reserves and correlates with fetal iron status at birth. AIM: The purpose of the study was to examine role of cord blood ferritin in predicting iron stores at term vs late preterm neonates between 34weeks – 36weeks. METHODOLOGY: A hospital based analytical cross-sectional study was undertaken in the Department of Paediatrics, SRM Medical College Hospital and Research Centre, Tamil Nadu from May 2025 to January 2026. A total of 96 neonates (48 term, 48 late preterm) born between 34+0 and 41+6 weeks of gestation were enrolled after informed maternal agreement was obtained. Exclusion criteria included neonates with sepsis, congenital malformations, cyanotic heart disease, Rh isoimmunization, and substantial maternal diseases. The umbilical cord venous blood was obtained soon after birth for serum ferritin determination by chemiluminescent immunoassay. RESULTS: Maternal parameters (age, parity, iron supplementation, hemoglobin, method of birth and obstetric problems) were equivalent in both groups (P>0.05). Late preterm neonates had a significantly different birth weight distribution and higher NICU admissions (22.9% vs. 4.2%, P=0.007). The term neonates had substantially greater gestational age (38.31±1.00 vs 34.85±0.77 weeks), birth weight (3.06±0.26 vs 2.41±0.21 kg), cord ferritin levels (170.14±29.18 vs 110.57±23.17 ng/mL) and Apgar scores (P<0.001). There was a strong positive connection between cord serum ferritin and gestational age (r=0.629, P<0.001). CONCLUSION: Our observations show that iron stores are reduced after delivery, as seen by considerably lower cord serum ferritin concentrations in late preterm infants compared with term infants. Ferritin levels in cord associated favorably with gestational age indicating that it may be an early marker of newborn iron status. Early detection may allow the timely monitoring and interventions to prevent the iron deficiency later.