Maternal iron status during early pregnancy and school‐age, lung function, asthma, and allergy: The Generation R Study

Quezada-Pinedo, Hugo G.; Mensink‐Bout, Sara M.; Jaddoe, Vincent W. V.; Vermeulen, Marijn J.; Duijts, Liesbeth

doi:10.1002/ppul.25324

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…Ferritin was measured by electrochemiluminescence immunoassay on the Cobas e411 analyzer (Roche). Iron was measured by colorimetric assay and transferrin by immunoturbidimetric assay, both by the C502 module on the Cobas 8000 (Roche) ( 32 ). As serum ferritin is considered the gold standard to assess iron stores, we used serum ferritin concentrations as our primary exposure ( 33 ).…”

Section: Methodsmentioning

confidence: 99%

Maternal Iron Status in Early Pregnancy and Blood Pressure Throughout Pregnancy, Placental Hemodynamics, and the Risk of Gestational Hypertensive Disorders

Taeubert

Wiertsema

Vermeulen

et al. 2022

The Journal of Nutrition

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Background In non-pregnant populations, higher serum ferritin, which reflects high iron stores, is associated with an increased risk of hypertension. We hypothesized that a dysregulated maternal iron status in early pregnancy may lead to impaired gestational hemodynamic adaptations, leading to an increased risk of gestational hypertensive disorders. Objective Examine the associations of maternal iron status with maternal blood pressure, placental hemodynamic parameters and the risks of gestational hypertensive disorders. Methods In a population-based prospective cohort study among 5983 pregnant women, we measured maternal serum ferritin, transferrin saturation, serum iron and transferrin concentrations at median 13.2 weeks gestation (95% range 9.6, 17.6). Maternal blood pressure was measured in early-, mid-, and late pregnancy, and placental hemodynamic parameters in mid- and late pregnancy by ultrasound. Information on gestational hypertensive disorders was collected from medical records. We examined the associations of maternal early pregnancy iron status with maternal systolic and diastolic blood pressure, placental hemodynamic parameters and the risks of gestational hypertensive disorders using linear and logistic regression models. Results Higher maternal early pregnancy serum ferritin concentrations were associated with higher systolic and diastolic blood pressure throughout pregnancy in the basic models (P-values < 0.05). After adjustment for maternal inflammation, sociodemographic and lifestyle factors, higher maternal early pregnancy serum ferritin concentrations were only associated with a higher early pregnancy diastolic blood pressure (0.27 (95% CI 0.03, 0.51) mmHg per SDS increase in serum ferritin) and with a higher mid pregnancy umbilical artery pulsatility index (P-value < 0.05). No associations were present with the risk of gestational hypertensive disorders. Conclusion No consistent associations of maternal iron status in early pregnancy with gestational hemodynamic adaptations or the risks of gestational hypertensive disorders were present. Further studies are needed to examine the potential role of iron metabolism in the development of gestational hypertensive disorders within higher risk populations.

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Section: Methodsmentioning

confidence: 99%

Maternal Iron Status in Early Pregnancy and Blood Pressure Throughout Pregnancy, Placental Hemodynamics, and the Risk of Gestational Hypertensive Disorders

Taeubert

Wiertsema

Vermeulen

et al. 2022

The Journal of Nutrition

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“…Low maternal hemoglobin levels are also associated with increased IgE antibody levels and lower lung volume in the child. Higher maternal transferrin concentrations during pregnancy, reflecting a lower iron status, were associated with an increased risk of a child's physician-diagnosed inhalant allergy ( 238 ). In an Italian study, supplementing mothers with iron and folic acid during their pregnancy compared to women without nutrient supplementation reduced the risk of their children developing atopic dermatitis by the age of 6 years by 80% ( 176 ).…”

Section: Epidemiology and Clinical Evidence Of Iron Deficiency In Ato...mentioning

confidence: 99%

Iron-Deficiency in Atopic Diseases: Innate Immune Priming by Allergens and Siderophores

Roth‐Walter

2022

Front. Allergy

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Although iron is one of the most abundant elements on earth, about a third of the world's population are affected by iron deficiency. Main drivers of iron deficiency are beside the chronic lack of dietary iron, a hampered uptake machinery as a result of immune activation. Macrophages are the principal cells distributing iron in the human body with their iron restriction skewing these cells to a more pro-inflammatory state. Consequently, iron deficiency has a pronounced impact on immune cells, favoring Th2-cell survival, immunoglobulin class switching and primes mast cells for degranulation. Iron deficiency during pregnancy increases the risk of atopic diseases in children, while both children and adults with allergy are more likely to have anemia. In contrast, an improved iron status seems to protect against allergy development. Here, the most important interconnections between iron metabolism and allergies, the effect of iron deprivation on distinct immune cell types, as well as the pathophysiology in atopic diseases are summarized. Although the main focus will be humans, we also compare them with innate defense and iron sequestration strategies of microbes, given, particularly, attention to catechol-siderophores. Similarly, the defense and nutritional strategies in plants with their inducible systemic acquired resistance by salicylic acid, which further leads to synthesis of flavonoids as well as pathogenesis-related proteins, will be elaborated as both are very important for understanding the etiology of allergic diseases. Many allergens, such as lipocalins and the pathogenesis-related proteins, are able to bind iron and either deprive or supply iron to immune cells. Thus, a locally induced iron deficiency will result in immune activation and allergic sensitization. However, the same proteins such as the whey protein beta-lactoglobulin can also transport this precious micronutrient to the host immune cells (holoBLG) and hinder their activation, promoting tolerance and protecting against allergy. Since 2019, several clinical trials have also been conducted in allergic subjects using holoBLG as a food for special medical purposes, leading to a reduction in the allergic symptom burden. Supplementation with nutrient-carrying lipocalin proteins can circumvent the mucosal block and nourish selectively immune cells, therefore representing a new dietary and causative approach to compensate for functional iron deficiency in allergy sufferers.

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“…Iron biomarkers were measured in non-fasting blood serum and plasma samples collected during early pregnancy and processed as described previously ( 17 ) . Gestational age at iron blood sampling was at mean 13⋅4 ( sd 2⋅0) weeks, based on ultrasound examinations in early pregnancy ( 15 ) .…”

Section: Methodsmentioning

confidence: 99%

“…To allow comparison with studies that used other measures of iron status, secondary analyses were done on transferrin saturation and haemoglobin concentration. Transferrin saturation, reflecting the iron-bound part of the total iron-binding capacity, was calculated using the formula (serum iron×100)/transferrin×25⋅1 ( 17 ) . Serum iron was determined by colorimetric assay and transferrin by immunoturbidimetric assay, both measured with C502 on the Cobas 8000 (Roche, Almere, The Netherlands).…”

Section: Methodsmentioning

confidence: 99%

“…Serum iron was determined by colorimetric assay and transferrin by immunoturbidimetric assay, both measured with C502 on the Cobas 8000 (Roche, Almere, The Netherlands). Haemoglobin, as well as high sensitivity CRP concentrations, were measured in venous EDTA plasma samples as previously described ( 17 , 23 ) . Anaemia was defined as haemoglobin <11 g/dl, and iron-deficiency anaemia as ferritin <15 μg/l + haemoglobin <11 g/dl ( 3 ) .…”

Section: Methodsmentioning

confidence: 99%

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Ethnic differences in adverse iron status in early pregnancy: a cross-sectional population-based study

et al. 2022

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We studied ethnic differences in terms of iron status during pregnancy between Dutch women and other ethnicities and explore to what extent these differences can be explained by environmental factors. This cross-sectional population-based study (2002–2006) was embedded in the Generation R study and included a total of 4737 pregnant women from seven ethnic groups (Dutch, Turkish, Moroccan, Cape Verdean, Surinamese-Hindustani, Surinamese-Creole and Antillean). Ethnicity was defined according to the Dutch classification of ethnic background. Ferritin, iron and transferrin were measured in early pregnancy. The overall prevalence of iron deficiency was 7 %, ranging from 4 % in both Dutch and Surinamese-Creoles, to 18 % in Turkish, Moroccan and Surinamese-Hindustani women. Iron overload was most prevalent in Surinamese-Creole (11 %) and Dutch (9 %) women. Socioeconomic factors accounted for 5–36 % of the differences. Income was the strongest socioeconomic factor in the Cape Verdean and Surinamese-Hindustani groups and parity for the Turkish and Moroccan groups. Lifestyle determinants accounted for 8–14 % of the differences. In all groups, the strongest lifestyle factor was folic acid use, being associated with higher iron status. In conclusion, in our population, both iron deficiency and iron overload were common in early pregnancy. Our data suggest that ethnic differences in terms of socioeconomic and lifestyle factors only partly drive the large ethnic differences in iron status. Our data support the development of more specific prevention programmes based on further exploration of socioeconomic inequities, modifiable risk and genetic factors in specific ethnic subgroups, as well as the need for individual screening of iron status before supplementation.

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Maternal iron status during early pregnancy and school‐age, lung function, asthma, and allergy: The Generation R Study

Cited by 12 publications

References 29 publications

Maternal Iron Status in Early Pregnancy and Blood Pressure Throughout Pregnancy, Placental Hemodynamics, and the Risk of Gestational Hypertensive Disorders

Maternal Iron Status in Early Pregnancy and Blood Pressure Throughout Pregnancy, Placental Hemodynamics, and the Risk of Gestational Hypertensive Disorders

Iron-Deficiency in Atopic Diseases: Innate Immune Priming by Allergens and Siderophores

Ethnic differences in adverse iron status in early pregnancy: a cross-sectional population-based study

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