Uttara Aiyer Kohli1, Meenakshi Rajput2, S Venkatesan3. 1. Associate Professor (Obstetrics & Gynecology), Command Hospital (Air Force), Bangalore, 560007, India. 2. Graded Specialist (Obstetrics & Gynecology), Command Hospital (Northern Command), C/o 56 APO, India. 3. Associate Professor, Department of Pathology & Hematopathology, Armed Forces Medical College, Pune, 411040, India.
Abstract
BACKGROUND: One of the commonest causes of anemia in pregnancy is iron deficiency. This study aims at understanding and exploring the association between fetal and maternal iron status. Predelivery maternal hemoglobin (Hb) and iron stores, serum iron, ferritin, and soluble transferrin receptor (sTfR), were assessed and compared to the cord blood Hb and iron stores with an attempt to identify the level of maternal Hb and ferritin at which the fetal iron stores reduce, helping to identify the neonates who will require earlier iron supplementation. METHOD: Four hundred eight participants were enrolled, and maternal and cord blood was collected at the time of delivery and tested for Hb and iron parameters. The results were statistically analyzed. RESULTS: Of all mothers, 27.2% mothers were anemic (Hb less than 11 g/dl). Of all newborns, 15.4% newborns had Hb less than 14 g/dl. There was a significant association between the maternal and cord blood iron, ferritin, sTfR and sTfR/log ferritin index. Eighty-five percent of the babies with cord blood Hb <14 g/dl had maternal serum ferritin (SF) <50 μg/L. Maternal SF <10 μg/l was associated with a significant number of babies with cord blood SF <75 μg/l (77.7%). One hundred sixty six neonates had sTfR 2 μg/ml or more. Of these, 80.7% had maternal SF <50 μg/l. Of the 115 newborns with a high sTfR/log ferritin index (>1.5), 56.5% had raised maternal sTfR (>2μg/ml). CONCLUSION: In view of a significant association between maternal and neonatal Hb and iron stores, newborns of mothers with iron deficiency anemia (IDA) during pregnancy should be monitored and followed up after birth for development of IDA and early iron supplementation.
BACKGROUND: One of the commonest causes of anemia in pregnancy is iron deficiency. This study aims at understanding and exploring the association between fetal and maternal iron status. Predelivery maternal hemoglobin (Hb) and iron stores, serum iron, ferritin, and soluble transferrin receptor (sTfR), were assessed and compared to the cord blood Hb and iron stores with an attempt to identify the level of maternal Hb and ferritin at which the fetal iron stores reduce, helping to identify the neonates who will require earlier iron supplementation. METHOD: Four hundred eight participants were enrolled, and maternal and cord blood was collected at the time of delivery and tested for Hb and iron parameters. The results were statistically analyzed. RESULTS: Of all mothers, 27.2% mothers were anemic (Hb less than 11 g/dl). Of all newborns, 15.4% newborns had Hb less than 14 g/dl. There was a significant association between the maternal and cord blood iron, ferritin, sTfR and sTfR/log ferritin index. Eighty-five percent of the babies with cord blood Hb <14 g/dl had maternal serum ferritin (SF) <50 μg/L. Maternal SF <10 μg/l was associated with a significant number of babies with cord blood SF <75 μg/l (77.7%). One hundred sixty six neonates had sTfR 2 μg/ml or more. Of these, 80.7% had maternal SF <50 μg/l. Of the 115 newborns with a high sTfR/log ferritin index (>1.5), 56.5% had raised maternal sTfR (>2μg/ml). CONCLUSION: In view of a significant association between maternal and neonatal Hb and iron stores, newborns of mothers with iron deficiency anemia (IDA) during pregnancy should be monitored and followed up after birth for development of IDA and early iron supplementation.
Authors: Jie Shao; Jingan Lou; Raghavendra Rao; Michael K Georgieff; Niko Kaciroti; Barbara T Felt; Zheng-Yan Zhao; Betsy Lozoff Journal: J Nutr Date: 2012-09-26 Impact factor: 4.798
Authors: Sunmin Lee; Ronnie Guillet; Elizabeth M Cooper; Mark Westerman; Mark Orlando; Tera Kent; Eva Pressman; Kimberly O O'Brien Journal: Pediatr Res Date: 2015-09-18 Impact factor: 3.756
Authors: Ashajyothi M Siddappa; Raghavendra Rao; Jeffrey D Long; John A Widness; Michael K Georgieff Journal: Neonatology Date: 2007-03-14 Impact factor: 4.035