Abstract

It is well acknowledged from observations in humans that iron deficiency during pregnancy can be associated with a number of developmental problems in the newborn and developing child. Due to the obvious limitations of human studies, the stage during gestation at which maternal iron deficiency causes an apparent impairment in the offspring remains elusive. In order to begin to understand the time window(s) during pregnancy that is/are especially susceptible to suboptimal iron levels, which may result in negative effects on the development of the fetus, we developed a rat model in which we were able to manipulate and monitor the dietary iron intake during specific stages of pregnancy and analyzed the developing fetuses. We established four different dietary-feeding protocols that were designed to render the fetuses iron deficient at different gestational stages. Based on a functional analysis that employed Auditory Brainstem Response measurements, we found that maternal iron restriction initiated prior to conception and during the first trimester were associated with profound changes in the developing fetus compared to iron restriction initiated later in pregnancy. We also showed that the presence of iron deficiency anemia, low body weight, and changes in core body temperature were not defining factors in the establishment of neural impairment in the rodent offspring.Our data may have significant relevance for understanding the impact of suboptimal iron levels during pregnancy not only on the mother but also on the developing fetus and hence might lead to a more informed timing of iron supplementation during pregnancy.

Highlights

  • The clinical importance and prevalence of iron deficiency (ID) make the understanding of this micronutrient deficiency an important challenge for both the scientific and medical communities

  • We established a feeding protocol in which rat dams were provided a customized iron-deficient diet that led to maternal iron deficiency (ID) but not to severe iron deficiency anemia (IDA)

  • Even though severe anemia was absent in the dams, we found progressively reduced serum iron levels, ranging from a .40% reduction at 15 days of gestation up to an 82% decrease at 21 days of gestation, relative to controls (CTLs; Figure 1B)

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Summary

Introduction

The clinical importance and prevalence of iron deficiency (ID) make the understanding of this micronutrient deficiency an important challenge for both the scientific and medical communities. North America alone bears 1.4% of the global burden of ID and IDA and it has been estimated that 35–58% of healthy women show some degree of ID, with a higher prevalence during pregnancy [1,2,3,4,5]. This high prevalence of ID during pregnancy seems at odds with the practice of routine iron supplementation as part of the prenatal care provided in most developed countries. Factors that contribute to the still high prevalence are complex and include concerns of early iron supplementation generating oxidative stress [6], a low compliance rate (50%) of taking iron supplements even with optimal motivation and guidance due to the undesirable adverse effects [7,8,9], and a rise in risk factors like type-2 diabetes and obesity that can cause ID and IDA despite adequate food intake [10,11,12,13]

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