PAE altered fetal iron distribution independent of maternal iron status in rats. The elevated iron content of fetal liver suggests that PAE may have limited iron availability for fetal erythropoiesis and brain development. Altered fetal iron distribution may partly explain why maternal ID substantially worsens growth and behavioral outcomes in PAE.

Objective Maternal iron needs increase 6-fold during pregnancy, but obesity interferes with iron absorption. We hypothesized that maternal obesity impairs fetal iron status. Study Design 316 newborns with risk factors for infantile iron deficiency anemia (IDA) were studied to examine obesity during pregnancy and neonatal iron status. Erythrocyte iron was assessed by cord blood hemoglobin (Hb), zinc protoporphyrin/heme (ZnPP/H) and reticulocyte-ZnPP/H and storage iron by serum ferritin. Results Women with body mass index ≥30 kg/m2, as compared with non-obese women, delivered larger offspring with higher reticulocyte-ZnPP/H, and lower serum ferritin concentrations (p<0.05 for both). With increasing BMI, estimated body iron was relatively lower (mg/kg) and the ratio of total Hb-bound iron (mg)/total body iron (mg) increased. Maternal diabetes compromised infant iron status, but multivariate analysis demonstrated that obesity was an independent predictor. Conclusions Obesity during pregnancy and excessive weight gain are independent risk factors for iron deficiency in the newborn.

Background Maternal anemia and several complications of pregnancy can affect fetal iron acquisition. Aim Because it is unknown whether the effects of demographic and maternal risk factors are summative, we examined cord iron status in newborns with multiple risk factors for acquiring iron deficiency (ID). Methods Cord blood indices from healthy control newborns with and without risk factors for newborn or infant ID were studied. Results Newborns with greater risk factors had poorer erythrocyte and storage iron status. Poorest status was seen if mothers with comorbid obesity and diabetes delivered large-for-gestation newborns. Findings highlight the importance of identifying risk factors.