Background: Strategies to prevent anaemia in preterm infants include drawing fewer
blood samples, the use of recombinant human erythropoietin and iron supplementation. Although
iron sulfate is the most commonly used pharmaceutical formulation for iron supplementation, there
are few studies comparing different iron salts in infants.
Objective: This is a study of retrospective data comparison of two groups of preterm infants receiving
erythropoietin to evaluate the efficacy of iron bisglycinate chelate to iron sulfate.
Subjects and Methods: Three-hundred infants of gestational age ≤32 weeks were enrolled: 225
were supplemented with iron sulfate (3 mg/kg/day) and 75 were supplemented with iron bisglycinate
chelate (0.75 mg/kg/day). The effect on erythropoiesis was assessed with a general linear
model that estimates the response variables (values for Haemoglobin, Haematocrit, absolute values
and percentage Reticulocytes, Reticulocyte Haemoglobin content) based on treatment, time, birth
weight, and gestational age.
Results: Supplementation with iron bisglycinate chelate at a dose of 0.75 mg/kg/day demonstrated
an efficacy comparable to iron sulfate at a dose of 3 mg/kg/day in both populations of preterm infants.
The two cohorts had similar erythropoietic response, without significant differences.
Conclusions: The higher bioavailability of iron bisglycinate chelate resulted in a lower load of
elemental iron, a quarter of the dose, and achieved equivalent efficacy compared to iron sulfate.
Iron bisglycinate chelate may appear to be an alternative to iron sulfate in the prevention and treatment
of preterm newborn anaemia.