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Novel interventions are urgently needed. Iron stimulates the growth of most bacteria and hypoferremia induced by the acute phase response is a key element of innate immunity. Cord blood, which has high levels of hemoglobin, iron and transferrin saturation, has hitherto been used as a proxy for the iron status of neonates. We investigated hepcidin-mediated redistribution of iron in the immediate post-natal period and tested the effect of the observed hypoferremia on the growth of pathogens frequently associated with neonatal sepsis. Healthy, vaginally delivered neonates were enrolled in a cohort study at a single center in rural Gambia (N\u2009=\u2009120). Cord blood and two further blood samples up to 96\u2009hours of age were analyzed for markers of iron metabolism. Samples pooled by transferrin saturation were used to conduct<jats:italic>ex-vivo<\/jats:italic>growth assays with<jats:italic>Staphylococcus aureus, Streptococcus agalactiae, Escherichia coli<\/jats:italic>and<jats:italic>Klebsiella pneumonia<\/jats:italic>. A profound reduction in transferrin saturation occurred within the first 12\u2009h of life, from high mean levels in cord blood (47.6% (95% CI 43.7\u201351.5%)) to levels at the lower end of the normal reference range by 24\u2009h of age (24.4% (21.2\u201327.6%)). These levels remained suppressed to 48\u2009h of age with some recovery by 96\u2009h. Reductions in serum iron were associated with high hepcidin and IL-6 levels.<jats:italic>Ex-vivo<\/jats:italic>growth of all sentinel pathogens was strongly associated with serum transferrin saturation. These results suggest the possibility that the hypoferremia could be augmented (e.g. by mini-hepcidins) as a novel therapeutic option that would not be vulnerable to antimicrobial resistance. Trial registration: The original trial in which this study was nested is registered at ISRCTN, number 93854442.<\/jats:p>","DOI":"10.1038\/s41598-019-52908-w","type":"journal-article","created":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T11:03:18Z","timestamp":1573556598000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Hepcidin mediates hypoferremia and reduces the growth potential of bacteria in the immediate post-natal period in human neonates"],"prefix":"10.1038","volume":"9","author":[{"given":"Sarah","family":"Prentice","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amadou T.","family":"Jallow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edrissa","family":"Sinjanka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momodou W.","family":"Jallow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebrima A.","family":"Sise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah J.","family":"Kessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Wegmuller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7634-0955","authenticated-orcid":false,"given":"Carla","family":"Cerami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5389-451X","authenticated-orcid":false,"given":"Andrew M.","family":"Prentice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,12]]},"reference":[{"key":"52908_CR1","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/S0140-6736(14)60496-7","volume":"384","author":"JE Lawn","year":"2014","unstructured":"Lawn, J. 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