Published online March 30, 2009
PEDIATRICS Vol. 123 No. 4 April 2009, pp. 1208-1216 (doi:10.1542/peds.2008-1047)
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REVIEW ARTICLE

Iron Homeostasis in the Neonate

Keith J. Collard, BSc, MSc, PhD

Peninsula Allied Health Centre, School of Health Professions, University of Plymouth, Plymouth, United Kingdom

The regulation of the availability of micronutrients is particularly critical during periods of rapid growth and differentiation such as the fetal and neonatal stages. Both iron deficiency and excess during the early weeks of life can have severe effects on neurodevelopment that may persist into adulthood and may not be corrected by restoration of normal iron levels. This article provides a succinct overview of our current understanding of the extent to which newborns, particularly premature newborns, are able (or not able) to regulate their iron status according to physiologic need. Postnatal development of factors important to iron homeostasis such as intestinal transport, extracellular transport, cellular uptake and storage, intracellular regulation, and systemic control are examined. Also reviewed are how factors peculiar to the sick and premature neonate can further adversely influence iron homeostasis and exacerbate iron-induced oxidative stress, predispose the infant to bacterial infections, and, thus, compromise his or her clinical situation further. The article concludes with a discussion of the areas of relative ignorance that require urgent investigation to rectify our lack of understanding of iron homeostasis in what is a critical stage of development.

Key Words: growth and development • iron homeostasis • infant • newborn • premature

Abbreviations: DMT-1—divalent metal transporter 1 • NTBI—non–transferrin-bound iron

Accepted Aug 21, 2008.


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