Maternal iron intake during pregnancy and birth outcomes: a cross-sectional study in Northwest China

Abstract

Previous studies have yielded conflicting results on the associations of maternal Fe intake with birth outcomes. This study aimed to investigate the associations between maternal Fe intake (total Fe from diet and supplements, dietary total Fe, haeme Fe, non-haeme Fe and Fe supplements use) and adverse birth outcomes in Shaanxi Province of Northwest China. In all, 7375 women were recruited using a stratified multistage random sampling method at 0-12 months (median 3; 10th-90th percentile 0-7) after delivery. Diets were collected by a validated FFQ and maternal characteristics were obtained via a standard questionnaire. The highest tertile of haeme Fe intake compared with the lowest tertile was negatively associated with low birth weight (LBW) (OR 0·68; 95 % CI 0·49, 0·94), small for gestational age (SGA) (OR 0·76; 95 % CI 0·62, 0·94) and birth defects (OR 0·55; 95 % CI 0·32, 0·89). Maternal haeme Fe intake was associated with a lower risk of intra-uterine growth retardation (IUGR) (medium tertile v. lowest tertile: OR 0·78; 95 % CI 0·61, 0·95; highest tertile v. lowest tertile: OR 0·76; 95 % CI 0·59, 0·93; P trend=0·045). The OR of LBW associated with Fe supplements use were as follows: during pregnancy: 0·72 (95 % CI 0·50, 0·95); in the second trimester: 0·67 (95 % CI 0·42, 0·98); in the third trimester: 0·47 (95 % CI 0·24, 0·93). We observed no associations of total Fe, dietary total Fe or non-haeme Fe intake with birth outcomes. The results suggest that maternal haeme Fe intake is associated with a reduced risk of LBW, SGA, IUGR and birth defects, and Fe supplements use during pregnancy reduces LBW risk.

Maternal dietary patterns during pregnancy derived by reduced-rank regression and birth weight in the Chinese population

“…Intake of MUFA and PUFA may be related to the increased BW and reduced risk of LBW (5,12) . Increased maternal haem Fe intake may protect against LBW and SGA (14) . The 107 food items were consolidated into twenty-four food groups (wheat, rice, potatoes, legumes, soyabean products, green vegetables, other vegetables, fungi, fruits, nuts, red meat, poultry, processed meat, dairy products, eggs, fish, snacks, fast food, soft drinks, alcohol drinks, sweets, oils, solid fats and condiments) based on China Food Composition Tables and the logic of intake (32) .…”

“…For the micronutrient, increased BW was associated with increasing pantothenic, biotin, Mg, vitamin D and vitamin B 12 intakes (12) . Total Fe intake from food and supplements, prenatal Fe use and the dietary haem Fe intake were also in relation to improved BW and related outcomes such as LBW and SGA (14)(15)(16) .…”

The association of maternal dietary folate intake and folic acid supplementation with small-for-gestational-age births: a cross-sectional study in Northwest China

“…The study design and methodology have been described in detail previously (15,16) . Briefly, a population-based crosssectional survey was conducted in Shaanxi Province of Northwest China from August to November 2013.…”

Estratégias Dietéticas Para a Gestação E Lactação

“…Maternal iron intake during pregnancy and birth outcomes: a cross-sectional study in Northwest China. Yang et al (2017a) Investigar as associações entre o consumo materno de ferro (Fe total de dieta e suplementos) e desfechos adversos de nascimento, na província de Shaanxi, no noroeste da China. O maior tercil de ingestão de ferro-heme, quando comparado ao menor tercil, esteve associado a: baixo peso ao nascer (BPN) (OR 0,68; IC 95%: 0,49 -0,194), ser pequeno para a idade gestacional (PIG) (OR 0,66; IC 95%: 0,62 -0,94) e apresentar defeitos congênitos (OR 0,55; IC 95%: 0,32 -0,89).…”

“…A Organização Mundial da Saúde preconiza, como parte do cuidado pré-natal, a suplementação de ácido fólico e ferro durante a gestação, com o intuito de prevenir o baixo peso ao nascer, bem como a anemia e a deficiência de ferro na gestante (WHO, 2012). Yang et al (2017a) investigaram, por meio de Questionário de Frequência Alimentar (QFA), a associação entre o consumo de ferro materno, oriundos da dieta e de suplementos, com os desfechos adversos ao nascimento. Ao todo, foram estudadas 7375 mulheres, entre 0 e 12 meses após o parto.…”