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Developmental Trends in Serum Iron, Transferrin, and Transferrin Saturation From Birth to 12 Months

Larsson, Marie LU ; Hellström-Westas, Lena ; Askelöf, Ulrica ; Götherström, Cecilia ; Domellöf, Magnus and Andersson, Ola LU orcid (2026) In Acta Pædiatrica p.1-9
Abstract
Aim
There is a need for updated reference intervals for iron status biomarkers during infancy. This study aimed to investigate reference interval trends and diurnal variation of iron, transferrin, and transferrin saturation in infants subjected to delayed cord clamping at birth (DCC).

Methods
Data analysis from population-based Swedish studies, including 362 term-born infants subjected to DCC ≥ 60 s. The 2.5th and 97.5th percentiles were calculated from serum samples: In cord blood, at 48–118 h, four months and 12 months. We used Spearman's rho to test for associations and Student's t-test to compare groups.

Results
Iron concentrations in cord blood were initially high, 14–41 μmol/L, and had decreased by... (More)
Aim
There is a need for updated reference intervals for iron status biomarkers during infancy. This study aimed to investigate reference interval trends and diurnal variation of iron, transferrin, and transferrin saturation in infants subjected to delayed cord clamping at birth (DCC).

Methods
Data analysis from population-based Swedish studies, including 362 term-born infants subjected to DCC ≥ 60 s. The 2.5th and 97.5th percentiles were calculated from serum samples: In cord blood, at 48–118 h, four months and 12 months. We used Spearman's rho to test for associations and Student's t-test to compare groups.

Results
Iron concentrations in cord blood were initially high, 14–41 μmol/L, and had decreased by 48–118 h to 6–16 μmol/L, remaining mainly constant thereafter. Conversely, early transferrin concentrations were low. Transferrin slowly increased; concentrations at 4 months were positively associated with the average weight gained per day, rho = 0.46, p < 0.001. A small diurnal difference in iron was observed at 48–118 h: Samples collected between 10:30–11:59 were, on average, 1.4 μmol/L (95% CI −2.8 to −0.0) lower compared with samples collected between 15:30–19:59.

Conclusion
Developmental trends in iron, transferrin, and transferrin saturation in the first year of life need to be considered in the interpretation of test results from infants.

Key Points

Modern, well-defined normative data describing iron, transferrin, and transferrin saturation during infancy are lacking.
Our study reports reference intervals and diurnal trends in infants who had undergone delayed clamping of the cord at birth.
Developmental trends rather than discrete reference intervals need to be considered. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Acta Pædiatrica
pages
1 - 9
publisher
Wiley-Blackwell
external identifiers
  • scopus:105036722147
ISSN
1651-2227
DOI
10.1111/apa.70558
language
English
LU publication?
yes
id
c37d74c6-8bba-4d1c-8fb6-a8fa0290d64b
date added to LUP
2026-04-28 13:04:10
date last changed
2026-05-16 04:00:39
@article{c37d74c6-8bba-4d1c-8fb6-a8fa0290d64b,
  abstract     = {{Aim<br/>There is a need for updated reference intervals for iron status biomarkers during infancy. This study aimed to investigate reference interval trends and diurnal variation of iron, transferrin, and transferrin saturation in infants subjected to delayed cord clamping at birth (DCC).<br/><br/>Methods<br/>Data analysis from population-based Swedish studies, including 362 term-born infants subjected to DCC ≥ 60 s. The 2.5th and 97.5th percentiles were calculated from serum samples: In cord blood, at 48–118 h, four months and 12 months. We used Spearman's rho to test for associations and Student's t-test to compare groups.<br/><br/>Results<br/>Iron concentrations in cord blood were initially high, 14–41 μmol/L, and had decreased by 48–118 h to 6–16 μmol/L, remaining mainly constant thereafter. Conversely, early transferrin concentrations were low. Transferrin slowly increased; concentrations at 4 months were positively associated with the average weight gained per day, rho = 0.46, p &lt; 0.001. A small diurnal difference in iron was observed at 48–118 h: Samples collected between 10:30–11:59 were, on average, 1.4 μmol/L (95% CI −2.8 to −0.0) lower compared with samples collected between 15:30–19:59.<br/><br/>Conclusion<br/>Developmental trends in iron, transferrin, and transferrin saturation in the first year of life need to be considered in the interpretation of test results from infants.<br/><br/>Key Points<br/><br/>Modern, well-defined normative data describing iron, transferrin, and transferrin saturation during infancy are lacking.<br/>Our study reports reference intervals and diurnal trends in infants who had undergone delayed clamping of the cord at birth.<br/>Developmental trends rather than discrete reference intervals need to be considered.}},
  author       = {{Larsson, Marie and Hellström-Westas, Lena and Askelöf, Ulrica and Götherström, Cecilia and Domellöf, Magnus and Andersson, Ola}},
  issn         = {{1651-2227}},
  language     = {{eng}},
  month        = {{04}},
  pages        = {{1--9}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Pædiatrica}},
  title        = {{Developmental Trends in Serum Iron, Transferrin, and Transferrin Saturation From Birth to 12 Months}},
  url          = {{http://dx.doi.org/10.1111/apa.70558}},
  doi          = {{10.1111/apa.70558}},
  year         = {{2026}},
}