{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T21:07:23Z","timestamp":1767474443156,"version":"3.45.0"},"reference-count":24,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,11]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Infants with Rh hemolytic disease may have iron overload given the ongoing hemolysis. In these infants, iron supplementation may be unnecessary or potentially even harmful. However, there is a paucity of literature to make evidence\u2010based recommendations.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n All neonates with Rh isoimmunization and evidence of fetal anemia were eligible for inclusion in this cohort study. Primary outcomes were serum ferritin and hemoglobin at birth, 3, 6, 9, and 12 months. Additional outcomes were the requirement of top\u2010up transfusion and iron therapy during infancy. Iron supplementation was given only if ferritin was <30 mcg\/L. Subgroup analysis was performed based on receipt of intrauterine transfusion (IUT).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Fifty\u2010Six infants were enrolled (gestation 35 \u00b1\u20092\u2009weeks, weight 2490 \u00b1\u2009480 g). Thirty\u2010Five neonates (62%) received\n IUT<\/jats:styled-content>\n and 21 (38%) received exchange transfusion. Median ferritin (mcg\/L) at birth, three\u2010 (\n n<\/jats:italic>\n =\u200946), six\u2010 (\n n<\/jats:italic>\n =\u200936), nine\u2010 (\n n<\/jats:italic>\n =\u200938), and 12\u2010months (\n n<\/jats:italic>\n =\u200935) were 846 [626, 1433], 695 [263, 1041], 219 [105, 601], 122 [42, 242], and 77 [42, 168], respectively. Concomitant hemoglobin (g\/\n dL<\/jats:styled-content>\n ) values were 14.3, 9.4, 10.9, 10.9, and 10.7, respectively. Serum ferritin was above age\u2010specific cut\u2010off in 53\/56 (95%) infants at birth and remained elevated in 16\/35 (46%) at 12 months. Top\u2010up transfusion was required in 26\/47 infants (55%). Iron supplementation was started in 14\/46 infants (30%). Ferritin and top\u2010up transfusion requirements were significantly higher in infants treated with\n IUT.<\/jats:styled-content>\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Infants with Rh isoimmunization demonstrate hyperferritinemia at birth, which can persist till 12 months, particularly in IUT\u2010treated infants. Routine iron supplementation should be deferred in IUT\u2010treated infants until 12 months.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/trf.18430","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T05:20:42Z","timestamp":1758864042000},"page":"2159-2167","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hematological and iron status in infants with Rh hemolytic disease: A prospective cohort study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4248-9855","authenticated-orcid":false,"given":"Satya","family":"Prakash","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3962-944X","authenticated-orcid":false,"given":"Ankit","family":"Verma","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tushar","family":"Sehgal","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukul","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Hematology All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1474-1451","authenticated-orcid":false,"given":"M. Jeeva","family":"Sankar","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6208-3057","authenticated-orcid":false,"given":"Ramesh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8939-6181","authenticated-orcid":false,"given":"Anu","family":"Thukral","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2013.208"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.181172"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2014.12.001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12061"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-023-04962-6"},{"key":"e_1_2_10_7_1","unstructured":"World health Organization.Guideline daily iron supplementation in infants and children.2016. World health Organization. 54 p."},{"key":"e_1_2_10_8_1","unstructured":"AndreiC VladareanuR.The Value of Reference Ranges for Middle Cerebral Artery Peak Systolic Velocity in the Management of Rhesus Alloimmunized Pregnancies."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.01.059"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.297"},{"key":"e_1_2_10_11_1","unstructured":"Recommendations | jaundice in newborn babies under 28\u2009days | guidance | NICE [Internet]. NICE; 2010.https:\/\/www.nice.org.uk\/guidance\/cg98\/chapter\/recommendations"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14233"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000100805"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365513.2019.1681028"},{"issue":"4","key":"e_1_2_10_15_1","first-page":"558","article-title":"The effect of intrauterine intravascular blood transfusion on iron metabolism in fetuses with Rh alloimmunization","volume":"77","author":"Nasrat HA","year":"1991","journal-title":"Obstet Gynecol"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1961.tb08168.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00072.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.117.155812"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2021.100866"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000264247"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40556-014-0013-z"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)81704-4"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(24)00314-4"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.54330"},{"volume-title":"Guideline on haemoglobin cutoffs to define anaemia in individuals and populations","year":"2024","key":"e_1_2_10_25_1"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.18430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T05:57:58Z","timestamp":1763186278000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.18430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":24,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/trf.18430"],"URL":"https:\/\/doi.org\/10.1111\/trf.18430","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"type":"print","value":"0041-1132"},{"type":"electronic","value":"1537-2995"}],"subject":[],"published":{"date-parts":[[2025,9,25]]},"assertion":[{"value":"2024-12-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}