Fetal iron status in maternal anemia

Abstract

Hemoglobin, serum iron, transferrin saturation and ferritin were measured on paired maternal and cord blood samples in 54 anemic (hemoglobin < 110 g/L) and 22 non-anemic (hemoglobin > or = 110 g/L) pregnant women at term gestation. The levels of hemoglobin, serum iron, transferrin saturation and ferritin were significantly low in the cord blood of anemic women, suggesting that iron supply to the fetus was reduced in maternal anemia. The linear relationships of these parameters with both maternal hemoglobin and maternal serum ferritin indicated that the fetus extracted iron in amounts proportional to the levels available in the mother. Infants of mothers with moderate and severe anemia had significantly lower cord serum ferritin levels and hence poor iron stores at birth. It is concluded that iron deficiency anemia during pregnancy adversely affects the iron endowment of the infant at birth.

Expression of ferritin receptor in placental microvilli membrane in pregnant women with different iron status at mid-term gestation

“…Extensive studies indicate that an increase in the expression of TfR in placental microvilli might be a result of a compensatory mechanism with regard to iron de®ciency and mild iron-de®ciency anemia in pregnant mothers (Huebers, 1990). However, the function of this compensatory system is believed to be limited based on the fact that the Tf saturation is remarkably decreased and the TfR expression is also hindered in pregnant women with severe iron de®ciency (Singla et al, 1996;Allen, 2000). In addition, it was reported that iron status in fetuses whose mothers were suffering from iron de®ciency is normal or nearly normal, being independent of maternal iron status (Gebre-Medhin & Birgegard, 1981;Dallman, 1989;Bhargava et al, 1991;Lao et al, 1991;Institute of Medicine, food and Nutrition Board, 1993;Hokama et al, 1996), although different results have been reported (Blot et al, 1999).…”

“…It has been reported (Finch et al, 1983) that low levels of plasma iron, as found in severe iron de®ciency, could result in damage to fetal tissues and reduced capacity of placental tissues to take up iron. Singla et al (1996) demonstrated that a mild degree of maternal anemia has little in¯uence on iron accretion in the fetus. However, with increasing severity of maternal anemia, the fetus accumulates less and less iron, and levels of serum iron, Tf saturation and ferritin in the cord blood of severely anemic women is markedly decreased.…”

“…However, with increasing severity of maternal anemia, the fetus accumulates less and less iron, and levels of serum iron, Tf saturation and ferritin in the cord blood of severely anemic women is markedly decreased. It is likely that severe iron de®ciency anemia itself, in addition to being able to reduce TfR expression in pregnant women (Singla et al, 1996;Allen, 2000), could damage the placenta and thus inhibit FnR expression. Further investigations are needed.…”

Study of Maternal and Perinatal outcome in moderate to severe degree iron deficiency anaemia in rural community

“…[15][16][17] In a multivariate regression analysis of data from 691 women in rural Nepal, adjusted decrements in neonatal weight of 38, 91, 187, and 153 g were associated with haemoglobin concentrations ≥ 20 90-109, 70-89 and < 70 g/L, respectively. A significant fall in birth weight due to increase in prematurity rate and intrauterine growth retardation has been reported when maternal haemoglobin levels were below 8.0 g/dl.…”

Iron fortification of infant formula

“…It has generally been considered that maternal Fe de®ciency during pregnancy has little effect on fetal, neonatal and infant Fe status because of preferential transfer of Fe from the mother to the fetus (Rios et al 1975;Morton et al 1988;Hussain et al 1997). Extreme maternal Fe de®ciency as occurs in developing countries may be an exception (Singla et al 1996). This view is now challenged by two prospective studies from Spain (Colomer et al 1990) and Jordan (Kilbride et al 1999), that have demonstrated a clear relationship between anaemia in pregnancy and anaemia in the infant at 1 year old.…”