Evidence map›Paper›PMID 31981986›Full record

ArticleEBioMedicine2020

Early postnatal hypoferremia in low birthweight and preterm babies: A prospective cohort study in hospital-delivered Gambian neonates.

James H Cross, Ousman Jarjou, Nuredin Ibrahim Mohammed, Santiago Rayment Gomez, Bubacarr J B Touray, Andrew M Prentice, Carla Cerami

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in EBioMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03353051 (Iron and Infection), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03353051 completednot on this map

Iron and Infection: Neonatal Nutritional Immunity (NeoInnate Study)

TypeobservationalSponsorLondon School of Hygiene and Tropical MedicineRan2017 to 2019Enrolled430ConditionsNeonatal Infection, Nutritional AnemiaArmsObservational study
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

James H CrossMedical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia.
Ousman JarjouMedical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia.
Nuredin Ibrahim MohammedMedical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia.
Santiago Rayment GomezCardiff University, Cardiff, Wales, CF10 3AT, United Kingdom.
Bubacarr J B TourayMedical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia.
Andrew M PrenticeMedical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia.
Carla CeramiMedical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia. Electronic address: ccerami@mrc.gm.
MRC Unit the Gambia · GMCardiff University · GB

Funding

Medical Research Council MC_U123292699Medical Research Council MC_UU_00026/3Medical Research Council MR/R010161/1
6 · The paper itself

Abstract

backgroundNeonates, particularly those born preterm (PTB) and with low birthweight (LBW), are especially susceptible to bacterial and fungal infections that cause an estimated 225,000 deaths annually. Iron is a vital nutrient for the most common organisms causing septicaemia. Full-term babies elicit an immediate postnatal hypoferremia assumed to have evolved as an innate defence. We tested whether PTB and LBW babies are capable of the same response.

methodsWe conducted an observational study of 152 babies who were either PTB (born ≥32 to <37 weeks gestational age) and/or LBW (<2500 g) (PTB/LBW) and 278 term, normal-weight babies (FTB/NBW). Blood was sampled from the umbilical cord vein and artery, and matched venous blood samples were taken from all neonates between 6-24 h after delivery. We measured haematological, iron and inflammatory markers.

findingsIn both PTB/LBW and FTB/NBW babies, serum iron decreased 3-fold within 12 h of delivery compared to umbilical blood (7·5 ± 4·5 vs 23·3 ± 7·1 ng/ml, P < 0·001, n = 425). Transferrin saturation showed a similar decline with a consequent increase in unsaturated iron-binding capacity. C-reactive protein levels increased over 10-fold (P < 0·001) and hepcidin levels doubled (P < 0·001). There was no difference in any of these responses between PTB/LBW and FTB/NBW babies.

interpretationPremature or low birthweight babies are able to mount a very rapid hypoferremia that is indistinguishable from that in normal term babies. The data suggest that this is a hepcidin-mediated response triggered by acute inflammation at birth, and likely to have evolved as an innate immune response against bacterial and fungal septicaemia.

trial registrationclinicaltrials.gov (NCT03353051). Registration date: November 27, 2017.

fundingBill & Melinda Gates Foundation (OPP1152353).

Indexed as

Infant, Low Birth WeightInfant, PrematureBiomarkersBirth WeightCase-Control StudiesDisease ResistanceFetal BloodGestational AgeHumansInfantInfant, NewbornIronMaleTime FactorsBiomarkersferrate ionIronCRPHepcidinIronLow birthweightNeonatesNutritional immunityPrematuritySepticaemiaSub-Saharan AfricaTransferrin saturation

Identifiers

PMID31981986
PMCPMC6992934
OpenAlexW3001172931

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.