Depleted iron stores without anaemia early in pregnancy carries increased risk of lower birthweight even when supplemented daily with moderate iron

Ribot, Blanca; Aranda, Núria; Viteri, Fernando E.; Hernández‐Martínez, Carmen; Canals, Josefa; Arija, Victoria

doi:10.1093/humrep/des026

Cited by 54 publications

(45 citation statements)

References 30 publications

(32 reference statements)

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“…In a study on the effect of Fe supplementation in pregnancy and its impact on newborns in Niger, Preziosi et al found 54 % of women to be Fe-deficient at 6 months of pregnancy (39) , which is more severe than our results. A recent study in Spain found Fe deficiency among 20 % of pregnant women in the first trimester, 54 % in the second and 66 % in the third, which is also more than in our study (40) . In a study on Swiss pregnant women (9) , Zimmermann et al found 16 % to be Fe-deficient in the second trimester and 40 % in the third, but they considered a less restrictive cut-off than us.…”

Section: Discussioncontrasting

confidence: 58%

Iodine and iron status of pregnant women in Lubumbashi, Democratic Republic of Congo

Habimana

Twite

Wallemacq

et al. 2013

Public Health Nutr.

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Objective: Adequate iodine and Fe intakes are imperative during pregnancy to prevent fetal defects, but such data are not available in the Democratic Republic of Congo. We aimed to assess iodine and Fe status in pregnant women from Lubumbashi. Design: Cross-sectional study. We measured urinary iodine concentration (UIC) in random urine samples using a modified Sandell-Kolthoff digestion method; the WHO reference medians were used to classify iodine intake as deficient, adequate, more than adequate or excessive. Serum ferritin concentrations were measured by immunoenzymatic assay and considered insufficient when ,12 ng/ml. Setting: Maternity units from rural, semi-urban and urban areas of Lubumbashi, Democratic Republic of Congo. Subjects: Two hundred and twenty-five randomly selected pregnant women attending prenatal consultation, seventy-five postpartum women and seventy-five non-pregnant women as controls. Results: Overall median UIC in pregnant women was 138 (interquartile range: 105-172) mg/l, indicating iodine deficiency, whereas postpartum and nonpregnant women had adequate iodine intake: median UIC 5 144 mg/l and 204 mg/l, respectively. Median UIC values were lower in late pregnancy than in early pregnancy: in the first, second and third trimester respectively 255 mg/l, 70 mg/l and 88 mg/l in the rural area; 306 mg/l, 166 mg/l and 68 mg/l in the semi-urban area; and 203 mg/l, 174 mg/l and 99 mg/l in the urban area. Fe was insufficient in 39 % of pregnant women compared with 21 % of non-pregnant and postpartum women. In the third trimester, deficiencies in both iodine and Fe were high: 40 %, 12 % and 18 % in the rural, semi-urban and urban areas, respectively. Conclusions: Our data suggest that pregnant women are at risk of iodine and Fe deficiencies in Lubumbashi. Country policies fighting against iodine and Fe deficiencies during pregnancy should be reinforced.

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Section: Discussioncontrasting

confidence: 58%

Iodine and iron status of pregnant women in Lubumbashi, Democratic Republic of Congo

Habimana

Twite

Wallemacq

et al. 2013

Public Health Nutr.

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“…Bu bebekler yenidoganlarm %6-7'sini olu §turmasina karçin, tüm yenidogan ölümlerinin ücte ikisi bu gruptandir (4,5). Demir eksikiigi anemisi olan gebe kadmlari içeren cok sayidaki çaliçmada gösterilmi §tir ki, demir verilmesi dogum agirligini iyile §tirmekte, ölüm oranini azaltmaktadir (6,7).…”

Section: Giriçunclassified

“…Demir eksikliginin fetal ve yenidogan etkilerinin önlenebilmesi için demir verilmesi mümkünse gebelik öncesinde veya erken gebelikte ba §lanmasi önerilmektedir (6).…”

Section: Giriçunclassified

Does maternal anemia affect the newborn?

Dane¹,

Arslan²,

Batmaz³

et al. 2013

Turk Pediatri Ars

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Amaç: Çaliçmamizin amací gebelikte mevcut oían aneminin ve yenidoganda etkilerini degerlendirmekti.Gereç ve Yöntem: Klinigimizde dogum yapan 307 gebenin hemoglobin (Hb), hematokrit (Hct) degerleri ve yenidoganlarin kordon kaninda bakilan Hb, Hct, bilirübin degerleri ile dogum §ekli, yenidogan kilosu, Apgar skorlarmí belirledik. Gebeler Hb degerinin 11,1 mg/dL ve üzerinde anemik olmayan, Hb degeri 11 mg/dL altmda oían anemik grup olmak üzere iki grupta degerlendirildi. Ayrica Hb degerinin >11,1 mg/dL, 11-10,1 mg/dL arasinda, iO-9,1mg/dLarasinda ve <9 mg/dL olmasi §eklinde dort grup olu §turuldu. Bulgular:Çali §maya 146 anemik, 161 anemik olmayan olgu dahil edildi. Anemik gebelerin düfük dogum agirhkli bebek dogurma oraní anlamli olarak yüksek idi (%11,6'ya kar §ilik % 4,3, p=0,029). Dü §ük dogum agirligi sikliginin anne Hb degeri 10 g/dL ve altmda oldugunda anlamli olarak arttigí saptandi (p=0,0045). Anemik gebelerin kordon kam Hb (17,49±2,4 g/dL'ye kar §ilik 18,1 ± 2,4; p=0,026) ve Hct (%53,3±7,4'e kar §ilik %55,6±7,2; p=0,006) degerleri anlamli olarak dü §ük bulundu. Çikarimlar: Gebelikteki anemi yenidoganm dü §ük dogum kilosu ile dogma riskini artirmakta ve Hb ve Hct degerlerini azaltmaktadir.Anemi taranmali ve dogum öncesinde tedavi edilmelidir. (Turk PedAr § 2013; 48:195-9) Anahtar sözcükler: Anemi, dü §ük dogum agirligí, hemoglobin, yenidogan Sumtnary Aim: In this study we aimed to evaluate the effect of maternal anemia on the newborn. Material and Method: We determined hemoglobin (Hb) and hematocrit (Hct) levels of 307 pregnant women who delivered in our clinic and Hb, Hct, bilirubin levels in the cord blood, mode of delivery and Apgar scores of their newborns. The pregnant women were evaluated in two groups according to their Hb levels with the ones with a Hb value above 11.1 mg/dl as the nonanemic group and the ones with a Hb value below 11 mg/dl as the anemic group. We also created four groups with Hb levels >11.1 mg/dl, between 11 and 10.1 mg/dl, between 10 and 9.1 mg/dl and <9 mg/dl. Results:We included 146 anemic and 161 nonanemic patients in the study. The rate of delivery of babies with low birth weight was significantly higher in the anemic group (11.6% vs. 4.3%, p=0.029). The rate of low birth weight was significantly higher in the patients with a Hb level of <10 mg/dl (62.5 % sensitivity 74.7% specificity). The cord blood Hb (17.49±2.4 g/dl vs. 18.1 ±2.4; p=0.026) and Hct levels (53.3±7.4 % vs. 55.6± 7.2 %; p=0.006) in the anemic group were significantly lower. Conclusions: Anemia in pregnancy increases the risk of low birth weight and lowers the levels of Hb and Hct of the newbom. Anemia should be screened and treated before delivery (TurkArch Ped2013; 48; 195-9)

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“…The prevalence of ID and IDA is higher in pregnancy, and IDA affects 18-38% of pregnant women worldwide (Lopez et al 2016; World Health Organization 2015). The worldwide prevalence of ID is twice that of IDA (Camaschella 2015), and studies in Western nations report ID in as many as 60% of pregnant women (Arija et al 2013; da Costa et al 2016; Harvey et al 2016; Ribot et al 2012). …”

Section: Perinatal Iron Deficiencymentioning

confidence: 99%

Maternal iron nutriture as a critical modulator of fetal alcohol spectrum disorder risk in alcohol-exposed pregnancies

Helfrich

Saini

Kling

et al. 2018

Biochem. Cell Biol.

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Alcohol consumption during pregnancy places the fetus at risk for permanent physical, cognitive, and behavioral impairments, collectively termed fetal alcohol spectrum disorders (FASD). However, prenatal alcohol exposure (PAE) outcomes vary widely, and growing evidence suggests that maternal nutrition is a modifying factor. Certain nutrients, such as iron, may modulate FASD outcomes. Untreated gestational iron deficiency (ID) causes persistent neurodevelopmental deficits in the offspring that affect many of the same domains damaged by PAE. Although chronic alcohol consumption enhances iron uptake and elevates liver iron stores in adult alcoholics, alcohol-abusing premenopausal women often have low iron reserves due to menstruation, childbirth, and poor diet. Recent investigations show that low iron reserves in during pregnancy are strongly associated with a worsening of several hallmark features in FASD including reduced growth and impaired associative learning. This review discusses recent clinical and animal model findings that maternal ID worsens fetal outcomes in response to PAE. It also discusses underlying mechanisms by which PAE disrupts maternal and fetal iron homeostasis. We suggest that alcohol-exposed, ID pregnancies contribute to the severe end of the FASD spectrum.

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Depleted iron stores without anaemia early in pregnancy carries increased risk of lower birthweight even when supplemented daily with moderate iron

Cited by 54 publications

References 30 publications

Iodine and iron status of pregnant women in Lubumbashi, Democratic Republic of Congo

Iodine and iron status of pregnant women in Lubumbashi, Democratic Republic of Congo

Does maternal anemia affect the newborn?

Maternal iron nutriture as a critical modulator of fetal alcohol spectrum disorder risk in alcohol-exposed pregnancies

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