Increased Incidence of Gram-Negative Neonatal Sepsis With Intramuscular Iron Administration

During a five-year period the incidence of neonatal sepsis was 20 times higher in Polynesian newborns compared with European newborns (11 per 1,000 vs. 0.6 per 1,000 total births). This high incidence in Polynesians was confined to a period when the infants were being given intramuscular iron dextran. When the iron administration was stopped the incidence of disease in Polynesians decreased from 17 per 1,000 to 2.7 per 1,000 total births. An analysis of the Polynesian iron-treated and non-iron-treated groups showed a statistically significant difference in the incidence of sepsis, the type of causative organism, and mortality. The data suggest that the iron dextran injections have impaired the immunity of the treated infants, making them more susceptible to Escherichia coli sepsis.