Prepregnancy Body Mass Index and Gestational Weight Gain Have No Negative Impact on Maternal or Neonatal Iron Status

Cao, Chang; Pressman, Eva K.; Cooper, Elizabeth; Guillet, Ronnie; Westerman, Mark; O’Brien, Kimberly

doi:10.1177/1933719115607976

Cited by 52 publications

(105 citation statements)

References 46 publications

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“…The high concentrations of hepcidin and ferritin measured here in cord blood are in accordance with previous observations [20][21][22][23][24][25][26][27][28][29][30]. Nevertheless, there are a handful of previous studies [21,24,31,32] involving measurements of S-hepcidin, sTfR, and S-ferritin sampled in late pregnancy as well as in cord blood. However, only two of these studies did include IL-6 [31,32].…”

Section: Discussionsupporting

confidence: 92%

“…Nevertheless, there are a handful of previous studies [21,24,31,32] involving measurements of S-hepcidin, sTfR, and S-ferritin sampled in late pregnancy as well as in cord blood. However, only two of these studies did include IL-6 [31,32]. Together with these studies, the present study emphasizes the important biochemical changes in iron status as well as acute-phase reactions that occur in the transition from late pregnancy to parturition in the cord blood.…”

Section: Discussionmentioning

confidence: 99%

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Is cord blood hepcidin influenced by the low-grade acute-phase response occurring during delivery? A small-scale longitudinal study

Hoppe

Hulthén

Samuelson

2018

The Journal of Maternal-Fetal & Neonatal Medicine

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Although S-ferritin, S-hepcidin, and sTfR were correlated during pregnancy, these relationships were not apparent in umbilical cord blood. Further, cord blood interleukin-6 indicated an activated acute-phase response, and sTfR, which is known to be unaffected by inflammation, indicated a low iron status in cord blood. Thus, instead of representing an enhanced iron status, the data appear to suggest that hepcidin and ferritin in cord blood may be influenced by the low-grade acute-phase response that occurs during delivery.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Is cord blood hepcidin influenced by the low-grade acute-phase response occurring during delivery? A small-scale longitudinal study

Hoppe

Hulthén

Samuelson

2018

The Journal of Maternal-Fetal & Neonatal Medicine

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“…The central finding of our study was that EPO concentration is higher in women with obesity, even when controlling for iron status and inflammation. Few other studies have explored the influence of obesity on EPO concentration; one study in adolescents [19] and another in Mexican adult women, which controlled for inflammation [20]. These studies found no differences in EPO between individuals with adequate weight or obesity.…”

Section: Discussionmentioning

confidence: 99%

Erythropoiesis and Red Cell Indices Undergo Adjustments during Pregnancy in Response to Maternal Body Size but not Inflammation

et al. 2020

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During human pregnancy, iron requirements gradually increase, leading to higher amounts of erythropoietin (EPO) and reticulocytes, and changes in erythrocyte size and density. Women with pregestational obesity experience “obesity hypoferremia” during pregnancy, which alters iron homeostasis. In this study we aimed to describe the relationship between EPO and iron nutrition status during nonanemic pregnancy, and to explore whether obesity and inflammation influence erythropoiesis and red cell indices. We conducted a secondary analysis of a cohort followed throughout pregnancy. Participants were nonanemic women assigned to two study groups based on pregestational body mass index (pgBMI): adequate weight (AW, n = 53) or obesity (Ob, n = 40). All received a multivitamin supplement. At gestational ages (GA) 13, 21, 28 and 34, we measured hemoglobin and red cell indices with an ACT-5DIFF hematology counter, and reticulocyte percentage by manual cell counting. EPO, interleukin (IL–6) and markers of iron status, i.e., hepcidin, serum transferrin receptor (sTfr) and ferritin, were measured by ELISA. Bivariate correlations showed that EPO was positively associated with pgBMI, GA, sTfr and IL-6, but negatively associated with hepcidin, ferritin and hemoglobin, and unrelated to iron intake. Generalized linear models adjusted for confounding factors showed that EPO and erythrocyte concentrations were significantly higher in women in the Ob group, while mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and red cell distribution width (RDW) were lower; reticulocytes and mean corpuscular hemoglobin concentration (MCHC) were not different. Differences were not altered when controlling for inflammation (IL–6). These changes suggest that, in addition to altering iron metabolism, a larger maternal body size during pregnancy results in higher erythropoiesis without increasing hemoglobin, which is exhibited in the latter being distributed among more and smaller erythrocytes.

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“…Some have documented that overweight women had an increased risk of low iron status and higher levels of hepcidin and maternal inflammation [17,27]. Others have shown no relation of obesity during pregnancy and iron status [28]. Furthermore, a study of two cohorts showed that higher BMI in early pregnancy was positively associated with hemoglobin and reduced risk of anemia [29].…”

Section: Discussionmentioning

confidence: 99%

Pre-pregnancy overweight and weight gain during pregnancy increase the risk of gestational anemia

Cantoral¹,

Christensen²,

Solano³

et al. 2020

Preprint

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Objective: To study the double burden of overweight and anemia in Mexican women during pregnancy and if pre-pregnancy body mass index (BMI) and weight gain are associated with the development of anemia. Methods: In a sample of 98 pregnant women from an ongoing birth cohort, weight and hemoglobin at different gestational weeks, as well as pre-pregnancy BMI (self-reported) were obtained. An adjusted logistic model for longitudinal data was used to estimate the probability of presenting anemia according to pre-pregnancy overweight status (BMI > 25kg/m 2 ) and weight gain, including an interaction term between these two variables. Results: At the end of pregnancy the combined prevalence of overweight and anemia was 18%. The probability of developing anemia was different from zero among overweight women at the beginning of pregnancy and weight gain > 6.5kg kg (up to 8%, p <0.05); furthermore, the prevalence was higher than zero in those women with a normal pre-pregnancy BMI (<25kg/m 2 ) and a weight gain < 12 Kg (up to 9%, p <0.05). Conclusion: anemia increases with the combinations of low weight gain in women with a normal pre-pregnancy BMI as well as excessive weight gain in women with pre-pregnancy overweight.

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Prepregnancy Body Mass Index and Gestational Weight Gain Have No Negative Impact on Maternal or Neonatal Iron Status

Cited by 52 publications

References 46 publications

Is cord blood hepcidin influenced by the low-grade acute-phase response occurring during delivery? A small-scale longitudinal study

Is cord blood hepcidin influenced by the low-grade acute-phase response occurring during delivery? A small-scale longitudinal study

Erythropoiesis and Red Cell Indices Undergo Adjustments during Pregnancy in Response to Maternal Body Size but not Inflammation

Pre-pregnancy overweight and weight gain during pregnancy increase the risk of gestational anemia

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