Maternal and infant iron status in HIV‐infected Malawian women and their exclusively breastfed infants

Abstract

Identifying infants at risk of early depletion of iron stores is essential to prevent postnatal iron deficiency. Maternal iron status may be a determinant of infant iron status, especially in the context of HIV where iron deficiency is common. We evaluated how iron status of HIV infected Malawian women related to iron status of their exclusively breastfed infants in the Breastfeeding, Antiretroviral and Nutrition Study. Participants were randomized to receive maternal lipid‐based nutrient supplements (LNS), providing 15 mg iron/d, or no LNS, and maternal, infant or no antiretroviral drugs. Infant iron status (Hb, log ferritin, log transferrin receptors TfR) at 2 (n=355) or 6 wk (n=165), and 24 wk (n=532) were regressed on corresponding maternal indicators, each corrected for inflammation (elevated C‐reactive protein and/or α‐1‐acid glycoprotein). Maternal Hb was marginally associated with infant Hb (6 wk β: 0.14, p=0.07; 24 wk β: 0.08, p=0.06). Maternal ferritin was related to infant ferritin only at 2 wk (β: 0.16, p<.01). Maternal TfR was associated with infant TfR at all periods (2 wk β: 0.14, 6 wk β: 0.30, 24 wk β: 0.21; all p<0.001). Maternal LNS predicted marginally lower maternal ferritin at 6 and 24 wk (p<0.1), but not maternal TfR, Hb or infant status. Given the observed maternal influence, optimizing maternal status at delivery and during lactation is important for reducing risk of iron depletion in infants.Grant Funding Source : CDC(U48‐DP000059‐01); Bill & Melinda Gates Foundation(OPP53107); CPC(NICHD 5 R24 HD050924)