Prevalence of anemia and associations between neonatal iron status, hepcidin, and maternal iron status among neonates born to pregnant adolescents

Lee, Sunmin; Guillet, Ronnie; Cooper, Elizabeth; Westerman, Mark; Orlando, Mark; Kent, Tera R.; Pressman, Eva K.; O’Brien, Kimberly

doi:10.1038/pr.2015.183

Cited by 58 publications

(71 citation statements)

References 36 publications

(37 reference statements)

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“…Maternal IL-6 increased 65% on average from midgestation to delivery (P , 0.0001), and hepcidin increased 25%. Similar to findings in the larger cohort (28), as a result of deliveryassociated inflammation, neonatal Fe status indicators were more strongly correlated with measures of maternal Fe status at midgestation than at delivery. Maternal sTfR at midgestation was positively associated with cord sTfR (r = 0.23; P = 0.02).…”

Section: Maternal and Neonatal Fe Statussupporting

confidence: 77%

“…Maternal and neonatal Fe status indicators and Fe regulatory hormones were measured, including hemoglobin, serum ferritin (SF), serum transferrin receptor (sTfR), hepcidin, and erythropoietin. Biochemical assessment methods have been described previously in the maternal (23) and neonatal (28) cohorts. Maternal anemia was defined in our cohort by using the Centers for Disease Control and Prevention (Atlanta, GA, USA) trimester‐specific definitions: hemoglobin, 11.0 g/dl in trimester 1 (,14.0 wk of gestation) and trimester 3 (≥28 wk of gestation) and hemoglobin, 10.5 g/dl in trimester 2 (14.0–27.9 wk of gestation) (29).…”

Section: Methodsmentioning

confidence: 99%

“…Neonatal Fe status depends on maternal Fe status, as insufficient maternal Fe supply may limit the amount of Fe that is available for placental transport. Because we previously reported a positive correlation between maternal Fe status and neonatal Fe status in the larger study cohort (28), we used mediation analyses to simultaneously model the effects of maternal and neonatal Fe status on placental Fe transporter mRNA expression and protein abundance. Each placental protein variable was modeled as a continuous outcome in a structural equation model that estimated the direct effects of maternal and neonatal Fe status and the mediation effect of neonatal Fe status, that is, the effect of maternal Fe status working through neonatal Fe status.…”

Section: Methodsmentioning

confidence: 99%

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Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans

et al. 2016

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The placenta richly expresses nonheme and heme Fe transport proteins. To address the impact of maternal and neonatal Fe status and hepcidin on the regulation of these proteins, mRNA expression and protein abundance of nonheme and heme Fe transport proteins were evaluated in placental tissue from 154 adolescents. Regression analyses found maternal Fe status was significantly associated with multiple placental nonheme and heme transporters, whereas neonatal Fe status was related to only 3 heme transporters. Across statistical analyses, maternal Fe status was consistently associated with the placental nonheme Fe importer transferrin receptor 1 (TfR1). Protein abundance of TfR1 was related to midgestation maternal serum ferritin (SF) (β = -0.32; P = 0.005) and serum TfR (β = 0.25; P = 0.024). Protein abundance of the heme importer, proton-coupled folate transporter, was related to neonatal SF (β = 0.30; P = 0.016) and serum TfR (β = -0.46; P < 0.0001). Neonatal SF was also related to mRNA expression of the heme exporter feline leukemia virus subgroup C receptor 1 (β = -0.30; P = 0.004). In summary, maternal Fe insufficiency during pregnancy predicts increased expression of the placental nonheme Fe transporter TfR1. Associations between placental heme Fe transporters and neonatal Fe status require further study.-Best, C. M., Pressman, E. K., Cao, C., Cooper, E., Guillet, R., Yost, O. L., Galati, J., Kent, T. R., O'Brien, K. O. Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans.

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Section: Maternal and Neonatal Fe Statussupporting

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans

et al. 2016

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“…The availability of newer approaches to evaluating iron homeostasis may lead to changes in this paradigm. A report by Lee and colleagues indicates a higher prevalence of newborn anemia and markers of decreased iron availability (decreased cord blood ferritin relative to reported values, increased serum sTfR) in children born to iron-deficient adolescent mothers [90]. Further investigation in this population is certainly warranted, particularly to identify the prevalence of maternal factors independently associated with newborn anemia, such as maternal obesity or tobacco use [91].…”

Section: Impact Of Id During Pregnancymentioning

confidence: 96%

Iron Deficiency and Iron Deficiency Anemia: Implications and Impact in Pregnancy, Fetal Development, and Early Childhood Parameters

2020

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A normal pregnancy consumes 500-800 mg of iron from the mother. Premenopausal women have a high incidence of marginal iron stores or iron deficiency (ID), with or without anemia, particularly in the less developed world. Although pregnancy is associated with a "physiologic" anemia largely related to maternal volume expansion; it is paradoxically associated with an increase in erythrocyte production and erythrocyte mass/kg. ID is a limiting factor for this erythrocyte mass expansion and can contribute to adverse pregnancy outcomes. This review summarizes erythrocyte and iron balance observed in pregnancy; its implications and impact on mother and child; and provides an overview of approaches to the recognition of ID in pregnancy and its management, including clinically relevant questions for further investigation.

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“…Infants born to mothers with iron deficiency during pregnancy have reduced cord ferritin concentrations at birth, with maternal ferritin concentrations of 12-13.6 µg/l suggested as thresholds below which fetal iron accretion is affected (Gaspar et al 1993;Hokama et al 1996;Sweet et al 2001;Jaime-Perez et al 2005;Shao et al 2012;Lee et al 2016). Infants born to mothers with mild/moderate iron deficiency anaemia (haemoglobin <110 g/l) during pregnancy have reduced iron stores at birth (Hokama et al 1996;Emamghorashi & Heidari 2004), while severe maternal iron deficiency anaemia (haemoglobin <70 g/l) results in reduced cord haemoglobin concentrations, in addition to reduced iron stores (El-Farrash et al 2012;Basu et al 2016).…”

Section: Maternal Iron Statusmentioning

confidence: 99%

The neonatal period: A missed opportunity for the prevention of iron deficiency and its associated neurological consequences?

McCarthy

Kiely

2019

Nutrition Bulletin

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Iron deficiency is the most common micronutrient deficiency worldwide. Iron is essential for the development of multiple organ systems, most especially the developing brain. Iron deficiency, particularly during sensitive periods of brain development, such as in early childhood, is associated with long‐lasting adverse consequences for cognition, motor function and behaviour. Little consideration has been given to iron deficiency in newborn infants and its potential health consequences. Fetal iron accretion is compromised by pregnancy complications such as pre‐term birth and gestational diabetes mellitus, and our work has identified an increased risk of low iron stores at birth from maternal lifestyle factors such as smoking and obesity. Early‐life events, including Caesarean section delivery, further add to the cumulative risk of neonatal iron deficiency, which can persist throughout infancy into early childhood. While investigations into the long‐term neurological consequences of neonatal iron deficiency are limited, there is evidence of poorer memory, motor function and language ability in children born iron deficient. Recently, we also identified significant behavioural consequences of neonatal deficiency persisting from 2 to 5 years of age, with effects particularly apparent in ‘high‐risk’ children born to obese or smoking mothers or delivered by Caesarean section. Interventions targeting the fetal/neonatal period could therefore represent a key opportunity for the prevention of iron deficiency and its associated long‐term health consequences. A dual approach is required, comprising public health strategies targeting prevention, to improve health in women of reproductive age, and the development of screening strategies for the early detection of iron deficiency in newborn infants.

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Prevalence of anemia and associations between neonatal iron status, hepcidin, and maternal iron status among neonates born to pregnant adolescents

Cited by 58 publications

References 36 publications

Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans

Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans

Iron Deficiency and Iron Deficiency Anemia: Implications and Impact in Pregnancy, Fetal Development, and Early Childhood Parameters

The neonatal period: A missed opportunity for the prevention of iron deficiency and its associated neurological consequences?

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