Zinc protoporphyrin/heme ratios in infants born to women with diabetes

Lesser, Karen B.; Schoel, S B; Widness, John A.; Kling, Pamela J.

doi:10.1016/j.ajog.2003.10.155

Cited by 2 publications

(12 citation statements)

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“…Previously, we found cord blood ZnPP/H, red cell counts, hemoglobin, and red cell index readings were stable under the same storage conditions [9] .…”

Section: Laboratory Methodsmentioning

confidence: 99%

“…Post-enrollment exclusion criteria also included newborns with abnormal newborn screen or elevated cord plasma erythropoietin levels. Because ZnPP/H rises with fetal hypoxia [8,9] , cord plasma erythropoietin level 6 3 SD above the expected mean in those without labor ( 6 56 mU/ml) or with labor ( 6 148 mU/ml) were used as exclusion criteria [12] .…”

Section: Methodsmentioning

confidence: 99%

“…Manual reticulocyte percentage was expressed as absolute number. Erythrocyte ZnPP/H was measured by Front-Face Hematofluorimeter (Aviv Biomedical Co., Lakewood, N.J., USA) after rinsing with phosphate-buffered saline (PBS) to remove interfering pigments, such as bilirubin [9,13] . Whole blood was centrifuged at 500 g for 4 min and plasma stored -70 ° C. Plasma erythropoietin levels were measured by radioimmunoassay (DSL, Webster, Tex., USA) and plasma iron by ferrozine reaction.…”

Section: Laboratory Methodsmentioning

confidence: 99%

“…The goal of the study was to enroll newborns without conditions known to exhibit hypoxemia. Because cord ZnPP/H is higher after diabetic pregnancy [9] , newborns were excluded for preexisting maternal diabetes mellitus, positive or questionable gestational diabetes screening (fasting glucose 1 7.0 mmol/l, abnormal screening 50 mg oral glucose tolerance test 1 7.2 mmol/l or abnormal 100 mg 3 h glucose tolerance test) [11] . Newborns were excluded for neonatal hypoglycemia (blood glucose !…”

Section: Methodsmentioning

confidence: 99%

“…ZnPP/H is higher in the fetal cord blood of hypoxemic fetuses, including the offspring of diabetic pregnancy [8] . In a related study, we found that cord ZnPP/H ratios in the offspring of diabetic pregnancy are correlated with diabetes control, with ratios highest in large-for-gestation (LGA) newborns [9] . The metabolic disturbances seen in diabetes during pregnancy included accelerated fetal growth velocity, increased tissue hypoxemia, increased plasma erythropoietin levels and increased erythropoiesis, necessitating increased iron utilization for hemoglobin [1] .…”

mentioning

confidence: 99%

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Zinc Protoporphyrin/Heme in Large-for-Gestation Newborns

Kleven¹,

Blohowiak²,

Kling³

2007

Neonatology

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Background: Zinc protoporphyrin/heme (ZnPP/H) ratios are indicators of incomplete erythrocyte iron delivery. ZnPP/H is more sensitive than measures of iron stores, such as plasma ferritin, in identifying early pre-anemic iron-deficient erythropoiesis. Cord ZnPP/H ratios are elevated in conditions associated with fetal hypoxia, such as diabetes mellitus during pregnancy. In chronic fetal hypoxemia, erythrocyte and hemoglobin syntheses are accelerated and iron is incorporated into erythrocytes. Cord ZnPP/H ratios are correlated with fetal size after diabetic pregnancy. Because fetal size is a surrogate for diabetes control, it is unclear whether glycemic control in diabetes mellitus or fetal size was the major determinant of ZnPP/H ratios and disturbed erythrocyte iron delivery. Objective: Our goal was to examine whether ZnPP/H ratios were elevated or were associated with growth in large-for-gestation newborns born to mothers without the diagnosis of diabetes mellitus. Methods: In cord blood samples from large and appropriately grown healthy newborns, we measured ZnPP/H and indices of erythropoiesis and iron status. Analyses included simple linear regression, Fisher’s exact, and unpaired t testing. Results: In the absence of diabetes mellitus, ZnPP/H in 25 large and 24 appropriately grown healthy newborns was similar, and the ratios were within the limits of previously reported normal cord ZnPP/H. Ratios were not correlated with plasma ferritin levels. In large newborns, but not appropriately grown newborns, ZnPP/H ratios were positively correlated with fetal growth (p < 0.03) and estimates of body hemoglobin (p <0.04). Conclusions: Despite 33% greater body hemoglobin mass observed in healthy large, compared to appropriately grown newborns, mean ZnPP/H was normal. Iron incorporation into erythrocytes in large newborns appears adequate. Because the association of ZnPP/H with size and estimated body hemoglobin was observed only in large newborns, factors determining ZnPP/H may differ between large and appropriately grown newborns.

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“…Previously, we found cord blood ZnPP/H, red cell counts, hemoglobin, and red cell index readings were stable under the same storage conditions [9] .…”

Section: Laboratory Methodsmentioning

confidence: 99%