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The objective of this study was to evaluate iron deficiency in preterm infants and determine impact of blood transfusions on serum iron (SI) and ferritin (FTN).A prospective evaluation of baseline and weekly hemoglobin (Hgb), hematocrit (Hct), SI, FTN levels in premature infants with birth weights (BWs) < 2,500 g or gestational age (GA) < 34 weeks was performed to determine the impact of GA, BW, and blood transfusion on iron status. Comparisons of the baseline and 1 month values of these measures were performed as well as pre- and posttransfusion.In 125 preterm infants, the mean Hgb, Hct, and SI levels at birth were lower for infants < 28 weeks GA. Post hoc analysis revealed statistically significant lower iron values in infants ≤ 28 weeks GA compared with infants at 28 to 34 weeks GA (p = 0.013) and infants ≥ 34 weeks GA (p = 0.007). FTN and SI values at 1 month were not significantly impacted by blood transfusions.Infants < 28 weeks have lower SI levels at birth. The SI and FTN at 1 month of age were not significantly influenced by blood transfusions.