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A survey of iron supplementation, iron status surveillance, and erythropoiesis stimulating agent use in level III NICUs in the United States

Journal of Perinatology (2024)Cite this article

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Multiple studies involving term infants report associations between iron deficiency and poor neurodevelopment [1]. Few studies have investigated this in preterm infants. There are many uncertainties about best practices for assuring iron sufficiency among preterm infants. The purpose of our study was to better understand the practices being used in the USA to prevent iron deficiency in preterm infants. We aimed to: (1) estimate the proportion of NICUs routinely providing enteral and intravenous iron supplementation to preterm patients, (2) summarize typical doses used, and (3) summarize the frequency of routine use of various iron status biomarkers and erythropoiesis stimulating agents (ESAs).

To generate a probability sample of NICUs, we obtained a publicly available, curated list of level III NICUs in the United States generated in collaboration with the AAP Section on Neonatal-Perinatal Medicine and continuously updated (Scott Snyder, personal communication). We stratified units by their designation as “academic/university-affiliated” vs. “not academically affiliated” and by geographic region and selected a stratified random sample. To estimate proportions with a margin of error of 10% with 95% confidence, a sample size of 60 units was needed.

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Data availability

A deidentified data set is available by contacting the corresponding author.

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Acknowledgements

The authors thank Dr. Scott Snyder of Boise, ID, for providing the curated list of level III NICUs from which the sample was obtained free-of-charge.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA

    Jared J. Tuttle, Timothy M. Bahr, Sarah M. Tweddell, Robert D. Christensen & Robin K. Ohls

  2. Division of Neonatology, Department of Pediatrics, Intermountain Health, Murray, UT, USA

    Timothy M. Bahr & Robert D. Christensen

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  1. Jared J. Tuttle
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  2. Timothy M. Bahr
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  3. Sarah M. Tweddell
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  4. Robert D. Christensen
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  5. Robin K. Ohls
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Contributions

JJT, TMB: conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, editing, and final approval of manuscript. SMT, RDC, RKO: conception and design, manuscript writing, data analysis and interpretation, editing, and final approval of manuscript.

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Correspondence to Timothy M. Bahr.

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Tuttle, J.J., Bahr, T.M., Tweddell, S.M. et al. A survey of iron supplementation, iron status surveillance, and erythropoiesis stimulating agent use in level III NICUs in the United States. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01950-2

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  • DOI: https://doi.org/10.1038/s41372-024-01950-2

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