Umbilical cord coiling in adolescent and multiples pregnancies: associations with iron status (636.4)

Abstract

Abnormal umbilical cord coiling has been associated with adverse neonatal outcomes. The etiology remains controversial. Perturbations in maternal and neonatal iron (Fe) homeostasis have been associated with abnormal cord coiling. This study was undertaken to examine associations between cord coiling and Fe status, in two obstetric groups at risk for iron deficiency (n=166): pregnant adolescents (蠄18 y, n= 95) and adult women carrying twins (n= 43) and triplets (n= 28). Umbilical cords were classified as hypo, normo, or hyper‐coiled using digital photographs to assess gross appearance after training on degree of coiling of actual cords. Hypo‐coiling and hyper‐coiling were observed in 46% (n=77) and 11.5% (n=19) of the study population. Adolescents with hyper‐coiled cords had lower serum ferritin (SF) (p = 0.01, n=11) and higher ratio of serum transferrin receptor (sTfR) to SF (p = 0.04, n=11) at mid‐gestation (27.7 ± 3.4 wks), and lower cord hepcidin (p= 0.02, n= 17) at birth (39.7± 1.5 wks) compared to teens with normo‐coiled cords (n=25 for SF and sTfR, n= 44 for hepcidin). The prevalence of hypo‐coiling observed among women carrying multiples was at least 3‐fold higher than the prevalence expected in singleton pregnancies. Data analyses for Fe status in multiples pregnancies are in progress. Findings to date suggest that decreased Fe status in adolescents is associated with hyper‐coiling of the umbilical cord.Grant Funding Source: Supported by USDA 2005‐35200; 2008‐01857; the Gerber Foundation