BACKGROUND: Large placental size and low birthweight have been implicated as factors predicting high blood pressure in adulthood. Maternal anaemia has been suggested as a link. We investigated the interaction between maternal iron status and other factors known to influence birthweight and placental size. METHODS: In a prospective study of 1650 low-risk, singleton, caucasian pregnancies, we related placental size and birthweight to maternal iron status, socioeconomic status, and parity. Placental morphology was assessed in 17 randomly chosen primigravid pregnancies. FINDINGS: Parity was an important determinant of birthweight (mean standard deviation score -0.13 [SD 0.90] para 0; -0.24 [0.90] para 1; 0.32 [1.1] para 2; 0.21 [1.1] para > or = 3; p<0.0001) and placental weight (mean 655 g [SD 130]; 679 g [122]; 675 g [139]; 694 g [157], respectively; p=0.01). Cigarette smoking influenced birthweight only. Socioeconomic status had little effect after correction for parity. In addition to parity, the factors influencing placental weight were maternal height, weight, and serum ferritin concentration at booking, but not haemoglobin concentration. Serum ferritin concentrations were associated with folate intake and parity. In the placental morphology subset, serum ferritin concentration was inversely related to overall measures of peripheral villous capillarization. Haemoglobin concentration showed no such association. INTERPRETATION: These findings show a relation between maternal anaemia and placental size and birthweight across the normal range for these measures. Low ferritin concentrations in early pregnancy were associated with increased placental vascularisation at term. The association between ferritin concentration and folate supplementation emphasises the importance of preconceptional health, particularly in women at high risk of iron deficiency.
BACKGROUND: Large placental size and low birthweight have been implicated as factors predicting high blood pressure in adulthood. Maternal anaemia has been suggested as a link. We investigated the interaction between maternal iron status and other factors known to influence birthweight and placental size. METHODS: In a prospective study of 1650 low-risk, singleton, caucasian pregnancies, we related placental size and birthweight to maternal iron status, socioeconomic status, and parity. Placental morphology was assessed in 17 randomly chosen primigravid pregnancies. FINDINGS: Parity was an important determinant of birthweight (mean standard deviation score -0.13 [SD 0.90] para 0; -0.24 [0.90] para 1; 0.32 [1.1] para 2; 0.21 [1.1] para > or = 3; p<0.0001) and placental weight (mean 655 g [SD 130]; 679 g [122]; 675 g [139]; 694 g [157], respectively; p=0.01). Cigarette smoking influenced birthweight only. Socioeconomic status had little effect after correction for parity. In addition to parity, the factors influencing placental weight were maternal height, weight, and serum ferritin concentration at booking, but not haemoglobin concentration. Serum ferritin concentrations were associated with folate intake and parity. In the placental morphology subset, serum ferritin concentration was inversely related to overall measures of peripheral villous capillarization. Haemoglobin concentration showed no such association. INTERPRETATION: These findings show a relation between maternal anaemia and placental size and birthweight across the normal range for these measures. Low ferritin concentrations in early pregnancy were associated with increased placental vascularisation at term. The association between ferritin concentration and folate supplementation emphasises the importance of preconceptional health, particularly in women at high risk of iron deficiency.
Authors: David Cantonwine; Howard Hu; Martha Maria Téllez-Rojo; Brisa N Sánchez; Héctor Lamadrid-Figueroa; Adrienne S Ettinger; Adriana Mercado-García; Mauricio Hernández-Avila; Robert O Wright Journal: Environ Health Date: 2010-07-26 Impact factor: 5.984
Authors: Emeir M Duffy; Maxine P Bonham; Julie M W Wallace; Chin-Kuo Chang; Paula J Robson; Gary J Myers; Philip W Davidson; Thomas W Clarkson; Conrad F Shamlaye; J J Strain Journal: Public Health Nutr Date: 2009-08-26 Impact factor: 4.022
Authors: Gerard J Casey; Davide Sartori; Susan E Horton; Tran Q Phuc; Luong B Phu; Dang T Thach; Tran C Dai; Giovanni Fattore; Antonio Montresor; Beverley-A Biggs Journal: PLoS One Date: 2011-09-08 Impact factor: 3.240
Authors: Kesha Baptiste-Roberts; Carolyn M Salafia; Wanda K Nicholson; Anne Duggan; Nae-Yuh Wang; Frederick L Brancati Journal: BMC Pregnancy Childbirth Date: 2008-09-23 Impact factor: 3.007
Authors: Tran Q Phuc; Seema Mihrshahi; Gerard J Casey; Luong B Phu; Nong T Tien; Sonia R Caruana; Tran D Thach; Antonio Montresor; Beverley-Ann Biggs Journal: BMC Public Health Date: 2009-07-28 Impact factor: 3.295