human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : To determine if iron supplementation of 2 mg/kg per day , in addition to routine iron-fortified formula or mother 's milk , increased the hematocrit ( Hct ) at 36 weeks ' postmenstrual age ( PMA ) . METHODS : : Infants with a birth weight < 1500 g who reached 120 mL/kg per day of feedings before 32 weeks ' PMA were r and omly assigned to iron ( multivitamin with iron ) or control ( multivitamin ) from enrollment until 36 weeks ' PMA ( or discharge , if sooner ) . Investigators and caregivers were masked . Transfusion guidelines were used . The primary outcome was Hct at 36 weeks ' PMA . A nonparametric rank sum analysis was performed so that infants who died before 36 weeks and infants who were transfused could be included in an intention-to-treat analysis . Infants were ranked by death ( lowest rank ) then by number of transfusions ( next lowest ranks ) . For infants who survived and were not transfused , the 36-week PMA Hct was used for the rank . RESULTS : One hundred fifty infants were enrolled ( 76 iron , 74 controls ) . There were 2 deaths ( 1 in each group ) . One hundred other infants ( 47 iron , 53 controls ) received transfusion(s ) . There was no significant difference in the primary outcome ranking ( P = .59 ) , in the number of transfusions per subject ( P = .64 ) , or in 36-week Hct ( iron mean ± SD , 29.2 % ± 4.0 % ; control , 28.3 % ± 4.5 % ; mean difference and 95 % confidence interval 0.9 [ −0.5 to 2.3 ] ; P = .21 ) or reticulocyte count among survivors . No short-term adverse effects of iron supplementation were observed . CONCLUSIONS : Among infants < 1500 g birth weight  , iron supplementation , in addition to routine iron intake , did not significantly increase the 36-week Hct or the decrease number of transfusions OBJECTIVE : Low birth weight ( LBW ) infants are at increased risk of cognitive and behavioral problems and at risk for iron deficiency , which is associated with impaired neurodevelopment . We hypothesized that iron supplementation of LBW infants would improve cognitive scores and reduce behavioral problems . METHODS : In a r and omized controlled trial , 285 marginally LBW ( 2000–2500 g ) infants received 0 , 1 , or 2 mg/kg/day of iron supplements from 6 weeks to 6 months of age . At 3.5 years of age , these infants and 95 normal birth weight controls were assessed with a psychometric test ( Wechsler Preschool and Primary Scale of Intelligence ) and a question naire of behavioral problems ( Child Behavior Checklist ; CBCL ) . RESULTS : There were no significant differences in IQ between the LBW groups or LBW infants versus controls  .  Mean ( SD ) full-scale IQ was 105.2 ( 14.5 ) , 104.2 ( 14.7 ) , and 104.5 ( 12.7 ) in the placebo , 1 mg , and 2 mg groups , respectively ( P = .924 ) . However , for behavioral problems , there was a significant effect of intervention . The prevalence of children with CBCL scores above the US sub clinical cutoff was 12.7 % , 2.9 % , and 2.7 % in the placebo , 1-mg , and 2-mg groups , respectively ( P = .027 ) , compared with 3.2 % in controls . Relative risk ( 95 % confidence interval ) for CBCL score above cutoff in placebo-treated children versus supplemented was 4.5 ( 1.4–14.2 ) . CONCLUSIONS : Early iron supplementation of marginally LBW infants does not affect cognitive functions at 3.5 years of age but significantly reduces the prevalence of behavioral problems . The study suggests a causal relation between infant iron deficiency and later behavioral problems Background Low-birth-weight infants ( LBW ) are at an increased risk of iron deficiency that has been associated with impaired neurodevelopment . We hypothesized that iron supplementation of LBW infants improves cognitive scores and reduces behavioral problems until school age . Methods We r and omized 285 marginally LBW ( 2,000–2,500 g ) infants to receive 0 , 1 , or 2 mg/kg/day of iron supplements from 6 weeks to 6 months of age . At 7 years of age , 205 participants were assessed regarding cognition using Wechsler Intelligence Scale for Children ( WISC-IV ) and behavior using the parental question naires Child Behavior Checklist ( CBCL ) and Five  to Fifteen  ( FTF ) . Results There were no significant differences between the intervention groups in WISC-IV or FTF . However , the CBCL scores for externalizing problems were significantly different , in favor of supplemented children ( P=0.045 ) . When combining the supplemented groups , they had significantly lower scores for externalizing behavior compared with placebo ( median ( interquartile range ) : 44 [ 34;51 ] vs. 48.5 [ 41;56 ] P=0.013 ) , and their risk ratio ( 95 % confidence interval ) for a total behavioral score above the cutoff for clinical problems was 0.31 ( 0.09–1.0 ) , P=0.054 . Conclusion Lower scores of externalizing behavior in supplemented children support our previous findings at 3 years , and suggest that iron supplementation may have long-lasting effects on behavioral functions Background / Objectives : Low serum ferritin concentrations at birth , which reflect neonatal iron stores , track through to early childhood and have been associated with poorer neurodevelopmental outcomes . We aim ed to identify maternal , antenatal and birth-associated factors that influence iron stores at birth in a prospect i ve maternal – infant birth cohort . Subjects/ Methods : In a population -based , longitudinal , birth cohort in Irel and , 413 maternal – infant dyads with prospect ively collected lifestyle and clinical data from 15 weeks ’ gestation had umbilical cord serum ferritin concentrations measured . Regression models were developed to identify independent factors associated with cord ferritin concentrations . Results : Median ( IQR ) cord ferritin concentrations were 185.7 ( 131.7 , 385.5 ) μg/l , and 8 % ( n=33 ) of infants had low iron stores ( ferritin < 76 μg/l ) at birth . Maternal obesity ( BMI ⩾30 kg/m2 ) at 15 weeks ’ gestation ( adj . estimate ( 95 % confidence interval ( CI ) ) : −66.4 ( −106.9 , −25.9 ) μg/l , P<0.0001 ) and delivery by caesarean section ( −38.8 ( −70.2 , −7.4 ) μg/l , P=0.016 ) were inversely associated with cord ferritin concentrations . In addition , maternal smoking at 15 weeks ’ gestation ( adj . odds ratio ( 95 % CI ) : 2.9 ( 1.2 , 7 ) , P=0.020 ) and being born small-for-gestational age ( 3.4 ( 1.3 , 8.9 ) , P=0.012 ) were associated with an increased risk of low iron stores ( ferritin < 76 μg/l ) at birth . Conclusions : We have identified a number of potentially modifiable lifestyle factors that influence iron stores at birth , with the important role of overall maternal health and lifestyle during pregnancy highlighted . Public health policies targeting women of child-bearing age to improve nutrition and health outcomes should be prioritised for the health of the next generation ABSTRACT : Erythrocyte superoxide dismutase ( ESOD ) activity reflects copper utilization and the risk of copper deficiency . To investigate the possible effects of inorganic iron on the metabolism of copper in low birth weight infants , we have measured ESOD activities in three groups of infants receiving different iron supplements . Fifty-five low birth weight infants were r and omly assigned to receive daily from 28 d either 13.8 mg ( HiFe ) , 7 mg ( MidFe ) , or no elemental iron ( NatFe ) as iron edetate . At 27 d , 8 , 12 , and 20 wk postnatal age , infants were weighed and measured and hematologic indices , plasma ferritin , zinc , and copper concentrations , and ESOD activities were assayed . Anthropometrical and hematologic indices and plasma copper and zinc concentrations did not differ among treatment groups at any time , but at 20 wk , plasma ferritin concentrations [ ( μg/L ) mean ; SD ] were lower in the NatFe group ( 17 ; 2.0 ) than in the HiFe group ( 32 ; 1.9 : 95 % confidence interval for mean difference 6.6 to 22.0 , p < 0.01 ) . ESOD activities ( U/g Hb ) were similar in HiFe ( 1447 ; 263 ) , MidFe ( 1552 ; 322 ) , and NatFe ( 1538 ; 382 ) groups at 27 d , but by 20 wk activities in the HiFe group ( 1537 ; 211 ) were lower than in the MidFe ( 1789 ; 403:95 % confidence interval 38 to 466 , p < 0.05 ) and NatFe ( 1858 ; 304 : 95 % confidence interval 150 to 492 , p < 0.01 ) groups . The lower ESOD activities found in the HiFe group at 20 wk may reflect altered copper metabolism induced by the iron supplement , but the clinical importance of this observation is unknown BACKGROUND . Iron deficiency in early childhood may impair neurodevelopment . In a masked , r and omized , controlled trial of early versus late enteral iron supplementation in preterm infants with birth weights of < 1301 g , early iron supplementation reduced the incidence of iron deficiency and the number of blood transfusions . OBJECTIVE . We sought to examine whether early enteral iron supplementation improves neurocognitive and motor development in these infants . METHODS . Children who participated in the above mentioned trial were evaluated by applying the Kaufmann Assessment Battery for Children and the Gross Motor Function Classification Scale at the age of school entry . RESULTS . Of the 204 infants initially r and omized , 10 died and 30 were lost to follow-up . A total of 164 ( 85 % of the survivors ) were evaluated at a median corrected age of 5.3 years . In this population ( n = 164 ) , the mean ( ±SD ) mental processing composite in the early iron group was 92 ( ±17 ) versus 89 ( ±16 ) in the late iron group . An abnormal neurologic examination was found in 17 of 90 versus 26 of 74 , and a Gross Motor Function Classification Scale score of > 1 was found in 2 of 90 versus 5 of 74 , respectively . Fifty-nine of 90 children in the early iron group were without disability , compared with 40 of 74 in the late iron group . Severe disability was found in 5 of 90 versus 6 of 74 children and 67 of 90 versus 49 of 74 qualified for regular schooling , respectively . CONCLUSIONS . Early enteral iron supplementation showed a trend toward a beneficial effect on long-term neurocognitive and psychomotor development and showed no evidence for any adverse effect . Because the initial study was not design ed to evaluate effects on neurocognitive development , the power was insufficient to detect small but potentially clinical ly relevant improvements . Additional studies are required to confirm the trend towards a better outcome observed in the early iron group Objective . Survival rates for preterm infants who weigh between 501 and 1500 g at birth have continued to improve over time . In response to this continuing decrease in birth weight of surviving preterm infants , Enfamil Human Milk Fortifier has recently been reformulated to meet the nutritional requirements of these smaller , more rapidly growing infants . It now provides an increased protein level of 1.1 g/58 kJ , a decreased carbohydrate level of 0.2 g/58 kJ , and a combined linoleic and α-linolenic fatty acid content of 157 mg/58 kJ. As these very small preterm infants have an increased requirement for dietary iron , the fortifier has been supplemented with 1.44 mg/58 kJ of iron , an amount of iron similar to that provided in a typical iron-fortified term infant formula . An iron-fortified product obviates the need for administration of an iron supplement , a hyperosmolar-inducing intervention . The purpose of this prospect i ve , double-blind , r and omized , controlled study was to evaluate growth , safety , and efficacy in a population of very low birth weight ( VLBW ) preterm infants who received human milk fortified with either the reformulated iron-fortified powdered human milk fortifier test product ( HMF-T ) or a powdered commercially available human milk fortifier control product ( HMF-C ) .  Methods . Infants who weighed ≤1500 g , had a gestational age ≤33 weeks postmenstrual age , and had an enteral intake of at least 100 mL/kg per day of unfortified human milk were stratified by gender and birth 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : To determine if iron supplementation of 2 mg/kg per day , in addition to routine iron-fortified formula or mother 's milk , increased the hematocrit ( Hct ) at 36 weeks ' postmenstrual age ( PMA ) . METHODS : : Infants with a birth weight < 1500 g who reached 120 mL/kg per day of feedings before 32 weeks ' PMA were r and omly assigned to iron ( multivitamin with iron ) or control ( multivitamin ) from enrollment until 36 weeks ' PMA ( or discharge , if sooner ) . Investigators and caregivers were masked . Transfusion guidelines were used . The primary outcome was Hct at 36 weeks ' PMA . A nonparametric rank sum analysis was performed so that infants who died before 36 weeks and infants who were transfused could be included in an intention-to-treat analysis . Infants were ranked by death ( lowest rank ) then by number of transfusions ( next lowest ranks ) . For infants who survived and were not transfused , the 36-week PMA Hct was used for the rank . RESULTS : One hundred fifty infants were enrolled ( 76 iron , 74 controls ) . There were 2 deaths ( 1 in each group ) . One hundred other infants ( 47 iron , 53 controls ) received transfusion(s ) . There was no significant difference in the primary outcome ranking ( P = .59 ) , in the number of transfusions per subject ( P = .64 ) , or in 36-week Hct ( iron mean ± SD , 29.2 % ± 4.0 % ; control , 28.3 % ± 4.5 % ; mean difference and 95 % confidence interval 0.9 [ −0.5 to 2.3 ] ; P = .21 ) or reticulocyte count among survivors . No short-term adverse effects of iron supplementation were observed . CONCLUSIONS : Among infants < 1500 g birth weight  , iron supplementation , in addition to routine iron intake , did not significantly increase the 36-week Hct or the decrease number of transfusions OBJECTIVE : Low birth weight ( LBW ) infants are at increased risk of cognitive and behavioral problems and at risk for iron deficiency , which is associated with impaired neurodevelopment . We hypothesized that iron supplementation of LBW infants would improve cognitive scores and reduce behavioral problems . METHODS : In a r and omized controlled trial , 285 marginally LBW ( 2000–2500 g ) infants received 0 , 1 , or 2 mg/kg/day of iron supplements from 6 weeks to 6 months of age . At 3.5 years of age , these infants and 95 normal birth weight controls were assessed with a psychometric test ( Wechsler Preschool and Primary Scale of Intelligence ) and a question naire of behavioral problems ( Child Behavior Checklist ; CBCL ) . RESULTS : There were no significant differences in IQ between the LBW groups or LBW infants versus controls  .  Mean ( SD ) full-scale IQ was 105.2 ( 14.5 ) , 104.2 ( 14.7 ) , and 104.5 ( 12.7 ) in the placebo , 1 mg , and 2 mg groups , respectively ( P = .924 ) . However , for behavioral problems , there was a significant effect of intervention . The prevalence of children with CBCL scores above the US sub clinical cutoff was 12.7 % , 2.9 % , and 2.7 % in the placebo , 1-mg , and 2-mg groups , respectively ( P = .027 ) , compared with 3.2 % in controls . Relative risk ( 95 % confidence interval ) for CBCL score above cutoff in placebo-treated children versus supplemented was 4.5 ( 1.4–14.2 ) . CONCLUSIONS : Early iron supplementation of marginally LBW infants does not affect cognitive functions at 3.5 years of age but significantly reduces the prevalence of behavioral problems . The study suggests a causal relation between infant iron deficiency and later behavioral problems Background Low-birth-weight infants ( LBW ) are at an increased risk of iron deficiency that has been associated with impaired neurodevelopment . We hypothesized that iron supplementation of LBW infants improves cognitive scores and reduces behavioral problems until school age . Methods We r and omized 285 marginally LBW ( 2,000–2,500 g ) infants to receive 0 , 1 , or 2 mg/kg/day of iron supplements from 6 weeks to 6 months of age . At 7 years of age , 205 participants were assessed regarding cognition using Wechsler Intelligence Scale for Children ( WISC-IV ) and behavior using the parental question naires Child Behavior Checklist ( CBCL ) and Five  to Fifteen  ( FTF ) . Results There were no significant differences between the intervention groups in WISC-IV or FTF . However , the CBCL scores for externalizing problems were significantly different , in favor of supplemented children ( P=0.045 ) . When combining the supplemented groups , they had significantly lower scores for externalizing behavior compared with placebo ( median ( interquartile range ) : 44 [ 34;51 ] vs. 48.5 [ 41;56 ] P=0.013 ) , and their risk ratio ( 95 % confidence interval ) for a total behavioral score above the cutoff for clinical problems was 0.31 ( 0.09–1.0 ) , P=0.054 . Conclusion Lower scores of externalizing behavior in supplemented children support our previous findings at 3 years , and suggest that iron supplementation may have long-lasting effects on behavioral functions Background / Objectives : Low serum ferritin concentrations at birth , which reflect neonatal iron stores , track through to early childhood and have been associated with poorer neurodevelopmental outcomes . We aim ed to identify maternal , antenatal and birth-associated factors that influence iron stores at birth in a prospect i ve maternal – infant birth cohort . Subjects/ Methods : In a population -based , longitudinal , birth cohort in Irel and , 413 maternal – infant dyads with prospect ively collected lifestyle and clinical data from 15 weeks ’ gestation had umbilical cord serum ferritin concentrations measured . Regression models were developed to identify independent factors associated with cord ferritin concentrations . Results : Median ( IQR ) cord ferritin concentrations were 185.7 ( 131.7 , 385.5 ) μg/l , and 8 % ( n=33 ) of infants had low iron stores ( ferritin < 76 μg/l ) at birth . Maternal obesity ( BMI ⩾30 kg/m2 ) at 15 weeks ’ gestation ( adj . estimate ( 95 % confidence interval ( CI ) ) : −66.4 ( −106.9 , −25.9 ) μg/l , P<0.0001 ) and delivery by caesarean section ( −38.8 ( −70.2 , −7.4 ) μg/l , P=0.016 ) were inversely associated with cord ferritin concentrations . In addition , maternal smoking at 15 weeks ’ gestation ( adj . odds ratio ( 95 % CI ) : 2.9 ( 1.2 , 7 ) , P=0.020 ) and being born small-for-gestational age ( 3.4 ( 1.3 , 8.9 ) , P=0.012 ) were associated with an increased risk of low iron stores ( ferritin < 76 μg/l ) at birth . Conclusions : We have identified a number of potentially modifiable lifestyle factors that influence iron stores at birth , with the important role of overall maternal health and lifestyle during pregnancy highlighted . Public health policies targeting women of child-bearing age to improve nutrition and health outcomes should be prioritised for the health of the next generation ABSTRACT : Erythrocyte superoxide dismutase ( ESOD ) activity reflects copper utilization and the risk of copper deficiency . To investigate the possible effects of inorganic iron on the metabolism of copper in low birth weight infants , we have measured ESOD activities in three groups of infants receiving different iron supplements . Fifty-five low birth weight infants were r and omly assigned to receive daily from 28 d either 13.8 mg ( HiFe ) , 7 mg ( MidFe ) , or no elemental iron ( NatFe ) as iron edetate . At 27 d , 8 , 12 , and 20 wk postnatal age , infants were weighed and measured and hematologic indices , plasma ferritin , zinc , and copper concentrations , and ESOD activities were assayed . Anthropometrical and hematologic indices and plasma copper and zinc concentrations did not differ among treatment groups at any time , but at 20 wk , plasma ferritin concentrations [ ( μg/L ) mean ; SD ] were lower in the NatFe group ( 17 ; 2.0 ) than in the HiFe group ( 32 ; 1.9 : 95 % confidence interval for mean difference 6.6 to 22.0 , p < 0.01 ) . ESOD activities ( U/g Hb ) were similar in HiFe ( 1447 ; 263 ) , MidFe ( 1552 ; 322 ) , and NatFe ( 1538 ; 382 ) groups at 27 d , but by 20 wk activities in the HiFe group ( 1537 ; 211 ) were lower than in the MidFe ( 1789 ; 403:95 % confidence interval 38 to 466 , p < 0.05 ) and NatFe ( 1858 ; 304 : 95 % confidence interval 150 to 492 , p < 0.01 ) groups . The lower ESOD activities found in the HiFe group at 20 wk may reflect altered copper metabolism induced by the iron supplement , but the clinical importance of this observation is unknown BACKGROUND . Iron deficiency in early childhood may impair neurodevelopment . In a masked , r and omized , controlled trial of early versus late enteral iron supplementation in preterm infants with birth weights of < 1301 g , early iron supplementation reduced the incidence of iron deficiency and the number of blood transfusions . OBJECTIVE . We sought to examine whether early enteral iron supplementation improves neurocognitive and motor development in these infants . METHODS . Children who participated in the above mentioned trial were evaluated by applying the Kaufmann Assessment Battery for Children and the Gross Motor Function Classification Scale at the age of school entry . RESULTS . Of the 204 infants initially r and omized , 10 died and 30 were lost to follow-up . A total of 164 ( 85 % of the survivors ) were evaluated at a median corrected age of 5.3 years . In this population ( n = 164 ) , the mean ( ±SD ) mental processing composite in the early iron group was 92 ( ±17 ) versus 89 ( ±16 ) in the late iron group . An abnormal neurologic examination was found in 17 of 90 versus 26 of 74 , and a Gross Motor Function Classification Scale score of > 1 was found in 2 of 90 versus 5 of 74 , respectively . Fifty-nine of 90 children in the early iron group were without disability , compared with 40 of 74 in the late iron group . Severe disability was found in 5 of 90 versus 6 of 74 children and 67 of 90 versus 49 of 74 qualified for regular schooling , respectively . CONCLUSIONS . Early enteral iron supplementation showed a trend toward a beneficial effect on long-term neurocognitive and psychomotor development and showed no evidence for any adverse effect . Because the initial study was not design ed to evaluate effects on neurocognitive development , the power was insufficient to detect small but potentially clinical ly relevant improvements . Additional studies are required to confirm the trend towards a better outcome observed in the early iron group Objective . Survival rates for preterm infants who weigh between 501 and 1500 g at birth have continued to improve over time . In response to this continuing decrease in birth weight of surviving preterm infants , Enfamil Human Milk Fortifier has recently been reformulated to meet the nutritional requirements of these smaller , more rapidly growing infants . It now provides an increased protein level of 1.1 g/58 kJ , a decreased carbohydrate level of 0.2 g/58 kJ , and a combined linoleic and α-linolenic fatty acid content of 157 mg/58 kJ. As these very small preterm infants have an increased requirement for dietary iron , the fortifier has been supplemented with 1.44 mg/58 kJ of iron , an amount of iron similar to that provided in a typical iron-fortified term infant formula . An iron-fortified product obviates the need for administration of an iron supplement , a hyperosmolar-inducing intervention . The purpose of this prospect i ve , double-blind , r and omized , controlled study was to evaluate growth , safety , and efficacy in a population of very low birth weight ( VLBW ) preterm infants who received human milk fortified with either the reformulated iron-fortified powdered human milk fortifier test product ( HMF-T ) or a powdered commercially available human milk fortifier control product ( HMF-C ) .  Methods . Infants who weighed ≤1500 g , had a gestational age ≤33 weeks postmenstrual age , and had an enteral intake of at least 100 mL/kg per day of unfortified human milk were stratified by gender and birth 
    Output:
    