Introduction: Iron transport across placenta occurs against concentration gradient and is energy dependent process. Growth restricted fetuses have increased iron demand due to accelerated erythropoiesis. This study was carried out tofind out iron status and RBC indices in term growth restricted neonates Method: Prospective analytical blinded study at a tertiary care hospital. 30 full term Asymmetrical Small for Gestation Age (ASGA) and 30 Full Term Appropriate for Gestation Age (AGA) infants were enrolled in the study. Cord blood was collected and analyzed for Serum Ferritin and RBC indices. Stored body iron (SBI) and Total body iron (TBI) were calculated. Results: Both the groups were comparable for maternal age, BMI, hemoglobin, iron supplementation & antenatal care. ASGA infants had significantly lower cord serum ferritin levels (Mean ferritin 283ng/ml[SD=157] vs 147ng/ml[SD=96.2], p<0.0001) and it showed linear correlation with birth weight (r=0.403, p=0.002) &Ponderal index (r=0.478, p<0.001). There was no significant difference in cord Hb& PCV between the two groups. RBC indices, MCV & MCH were higher in ASGA babies (Mean MCV 110fl [SD=5.91] vs. 114fl [SD=6.94]; p=0.011 and Mean MCH 35.5[SD=2.95] vs. 37[SD=1.67], p=0.022). Estimated SBI and TBI were significantly low in ASGA babies; SBI of 26.03mg (SD=18.13) vs. 66.81mg (SD=20.72), p<0.001 and TBI of 128mg [SD=23.37] vs 199.5mg [SD=37.72], p<0.001. Conclusion: Term ASGA neonates have significantly poor iron status. Microcytosis was not a feature of neonatal iron deficiency. This study supports rationale of early iron supplementation for term ASGA neonates. However further studies are required to determine exact timing and dosages of iron supplementation.
