Maternal Ferritin Research Articles

OP61 Is Maternal Iron Status Associated with offspring’s Blood Pressure and Adiposity? A Mendelian Randomization Study

BackgroundIron deficiency during pregnancy is a common problem. Experimental animal studies suggest that mothers deficient in iron during pregnancy are more likely to have offspring who become obese and have...

Exploring the relationship between maternal iron status and offspring’s blood pressure and adiposity: a Mendelian randomization study

BackgroundIron deficiency is the most common micronutrient deficiency worldwide. Experimental animal studies suggest that mothers deficient in iron during pregnancy are more likely to have offspring who become obese with high blood pressure. C282Y mutation carriers are more likely to have higher iron stores.MethodsWe undertook an instrumental variable (IV) analysis, using maternal C282Y as an indicator for the mother’s iron status, to examine its association with offspring blood pressure (BP), waist circumference (WC), and body mass index (BMI), and compared the results to that of ordinary least squares (OLS) regression. Offspring of a sub-cohort of mothers from the UK Women’s Cohort Study (UKWCS) were recruited in 2009–2010 (n = 348, mean age = 41 years). Their blood pressure, height, and weight were measured at their local general medical practice, and they were asked to self-measure their waist circumference. About half were offspring of C282Y carriers. Maternal ferritin was used as a biomarker of maternal iron status.ResultsMaternal C282Y was strongly associated with maternal ferritin (mean difference per allele = 84 g/L, 95% confidence interval: 31–137, P = 0.002). Using IV analyses, maternal ferritin was not linked to offspring’s BP, BMI, or WC. The first stage F-statistic for the strength of the instrument was 10 (Kleibergen–Paap rk LM P = 0.009). Maternal ferritin was linked to offspring diastolic BP, WC, and BMI in univariable, but not in multivariable OLS analysis. There was no difference between the OLS and the IV models coefficients for any of the outcomes considered.ConclusionWe found no association between maternal iron status and adult offspring’s BP and adiposity using both multivariable OLS and IV modeling. To our knowledge, this is the first study examining this relationship. Further exploration in larger studies that have genetic variation assessed in both mother and offspring should be considered.

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

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)

Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth Restriction

Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth RestrictionIntrauterine growth restriction is one of the leading causes of perinatal morbidity and mortality. Prediction of intrauterine growth restriction is one of the priority tasks of perinatal protection. The purpose of this study was to evaluate the levels of serum ferritin in pregnant women, which could point to a group of patients in whom possible development of fetal growth restriction could have been expected. In this investigation, we conducted a prospective study of healthy pregnant women between 30 and 32 gestational weeks, who were estimated for ferritin values. Newborn infants of low birth weight for gestational age were recorded in 8.1%. Anemia was not present in any of the patients who delivered low birth weight babies. Ferritin serum levels in mothers of the babies with low birth weight were on average 6.42 μg/L higher than in the mothers with appropriate for gestational age babies (p<0.005). ROC analysis of newborn infants birth weight and maternal blood ferritin levels showed that blood ferritin level had good predictive value. In case the recorded maternal blood ferritin values are above 13.6 μg/L, we can assume with the sensitivity of 64.7% and specificity of 91.7%, that the pregnant woman will develop a condition of intrauterine growth restriction. The missing decrease of ferritin values, erythrocytes, hemoglobin and hematocrit in the blood of healthy pregnant women between 30 and 32 gestational weeks, can with high probability point to the development of fetal intrauterine growth restriction.

Association of increased maternal ferritin levels with gestational diabetes and intra-uterine growth retardation

The objectives of the present study were to determine whether or not increased serum ferritin in women with premature labour is associated with gestational diabetes mellitus (GDM) and intra-uterine growth retardation (IUGR) and, if so, whether or not such increased levels reflect excess maternal iron stores, and have an effect on neonatal iron status and outcome. This prospective, single-hospital, observational study involved 63 mothers and their 90 preterm neonates. Full blood counts as well as serum ferritin, soluble transferrin receptor (sTfR) and erythropoietin concentrations were compared across the three study groups based on maternal ferritin levels at the time of delivery. Perinatal history, neonatal morbidity and early outcomes were also assessed. High maternal ferritin levels were significantly associated with higher rates of GDM and IUGR. However, there was no correlation between maternal ferritin and sTfR levels or between maternal and neonatal iron status. Elevated maternal ferritin is not a reflection of excess iron stores, but is related to an increased risk of GDM or IUGR. Also, maternal ferritin levels are not associated with either neonatal iron status or neonatal outcomes.

Iron Studies in Hemochromatosis During Pregnancy.

Abstract 5099Hereditary hemochromatosis is usually caused by a mutation in HFE gene that regulates iron uptake from the diet. The two most common mutations in the HFE gene are the well described C282Y and H63D mutations. Homozygous inheritance of either one of these mutations as well as compound heterozygous inheritance of one of each of the mutant alleles may result in a spectrum of phenotypic variants of the disease ranging from asymptomatic to multi-organ compromise. One half of a percent of the United States population carries two copies of the mutant HFE gene therefore making hemochromatosis the most common genetically inherited disease. On average one half of these patients will develop clinically significant disease.Usually hemochromatosis is a clinical diagnosis, however genetic testing as well as liver biopsy are utilized as confirmatory diagnostic modalities. Besides, hemochromatosis should be suspected in females with transferrin saturation over 45% and males over >50%. It is well established that in females hemochromatosis is usually identified later in life, likely secondary to menstruation, childbirth, and breastfeeding.We hypothesized that hemochromatotic women with elevated ferritin levels at time of conception probably do not require phlebotomies during the course of their pregnancies. In addition, this patient population likely does not require iron supplementation, otherwise indicated during pregnancy and breastfeeding.We are reporting a case of 36-year-old female found to be homozygous for C282Y mutation five months prior to becoming pregnant. This patient's transferrin saturation at the time of diagnosis was 75% and her ferritin level was 320ng/ml. Her past medical history is only significant for mitral valve prolapse. Her physical exam at the time of diagnosis was normal, except for a known II/IV systolic murmur. Although asymptomatic at presentation, this patient was found to have increased iron deposition in the liver detected with abdominal MRI. During the course of her pregnancy this patient received no iron supplementation and likewise she did not receive any phlebotomy treatments. Her iron studies were carefully monitored on average every four weeks to assess for phlebotomy or iron supplementation needs. The patient never became symptomatic from either iron overload or anemia during this pregnancy. Evidently the fetus was able to utilize maternal iron sufficiently with secondary benefit of decreasing maternal ferritin levels. Besides, despite withholding iron supplementation during pregnancy this patient did not develop a clinically significant degree of anemia. Likewise she did not develop any evidence of exacerbation of mitral valve prolapse symptoms – this complication is not uncommon during pregnancy secondary to anemia. A healthy child was delivered at term via normal vaginal delivery, with minimal complications secondary to umbilical cord enlargement without compression and a 1st degree perianal laceration with minimal blood loss. The iron panel on the child was not obtained.Date7/28/08 at diagnosis12/11/08 7 weeks of gestation1/12/09 13 weeks of gestation1/26/09 15 weeks of gestation2/23/09 19 weeks of gestation3/16/09 22 weeks of gestation4/13/09 26 weeks of gestation5/11/09 30 weeks of gestation6/08/09 34 weeks of gestation7/02/09 37 weeks of gestation7/20/09 6 days postpartumHemoglobin/Hematocrit (g/dL/%)14.3/40.013.7/38.412.9/36.012.1/34.111.7/33.511.6/34.013.2/36.113.1/36.712.6/35.413.2/37.013.3/38.3Serum Iron (μg/dL)15316920721423326026024728528795TIBC (μg/dL)203220217234243270311295295310307Ferritin (ng/mL)320258268220180147957566145174Transferrin Saturation (%)7577929192938492949331Maternal ferritin levels decreased significantly during the course of this pregnancy, reaching a nadir of 66ng/mL by 34 weeks of gestation, with subsequent rise to 145ng/mL two weeks prior to delivery.In conclusion, the favorable outcome of this case supports our stated hypothesis in at least the homozygous C282Y HFE gene mutation patient population with elevated preconception ferritin levels (to at least 320 ng/mL) and increased preconception transferrin saturations (to at least 75%). Further studies of hemochromatotic pregnant women with the aforementioned genotype (most common) as well as other hereditary hemochromatosis genotypes during both pregnancy, and breastfeeding may be warranted. DisclosuresNo relevant conflicts of interest to declare.

Iron status in pregnant women in the Republic of Seychelles.

To establish the Fe status of pregnant women and their neonates in the Republic of Seychelles. A prospective study. Republic of Seychelles. Pregnant women were recruited and blood samples taken at enrolment and post-delivery along with cord blood samples. Ferritin and soluble transferrin receptor (sTfR) were measured in maternal (n 220) and cord blood (n 123) samples. Maternal Fe deficiency (ferritin < 15 ng/ml, sTfR > 28 nmol/l) was present in 6 % of subjects at enrolment and in 20 % at delivery. There was no significant decrease in maternal ferritin. A significant increase in sTfR was observed between enrolment and delivery (P < 0.001). Maternal BMI and use of Fe supplements at 28 weeks' gestation were associated with improved maternal Fe status at delivery, whereas parity had a negative effect on sTfR and ferritin at delivery. Fe status of pregnant Seychellois women was, on average, within normal ranges. The incidence of Fe deficiency throughout pregnancy in this population was similar to that in a Westernised population. Increased awareness of the importance of adequate Fe intake during pregnancy, particularly in multiparous women, is warranted.

Maternal serum ferritin concentration in patients with preterm labor and intact membranes

Objective. To determine the relationship between maternal serum ferritin concentrations in the second trimester and the risk of preterm delivery (PTD).Methods. A prospective observational study was conducted. Fifty consecutive women with singleton pregnancies, who were admitted to the Maternal Fetal Medicine Unit due to preterm labor in the second trimester, were included. Maternal serum samples for determination of ferritin concentrations were obtained. Multiple logistic regression analysis was performed to control for confounders.Results. Out of fifty patients enrolled in the study, 38% (19/50) delivered prematurely. Eight women (16%) had maternal serum ferritin concentrations above 30 ng/ml in the second trimester. Among them, 75% (n = 6) subsequently presented with preterm delivery (odds ratio (OR) = 6.7 with 95% confidence interval (CI) 1.1–56.2, p = 0.04). Only two patients with increased maternal ferritin concentrations delivered at term. However, 13 patients with second trimester ferritin concentrations below 30 ng/ml had preterm delivery. No significant differences in mean maternal ferritin concentrations were found between patients who delivered preterm and those that delivered at term, 31.9 ± 50.6 vs. 13.6 ± 15.2, respectively (p = 0.064). Using a multivariable analysis, controlling for anemia, leucocytosis and maternal age, increased serum ferritin concentrations were found to be an independent risk factor for PTD (OR = 8.6; 95% CI 1.4–52.5; p < 0.019). No significant correlation was found between serum ferritin concentrations and gestational age at birth (Pearson correlation coefficient r = –0.093; p = 0.522).Conclusions. Maternal ferritin concentrations above 30 ng/ml in the second trimester can serve as a marker for preterm delivery. However, since no correlation was found between serum ferritin concentrations and gestational age at birth, the routine use of serum ferritin as a marker for preterm delivery warrants further investigation.

Maternal second-trimester serum ferritin concentrations and subsequent risk of preterm delivery.

We studied the relationship between maternal second-trimester serum ferritin concentrations and preterm delivery. The 312 preterm delivery cases, studied in aggregate and in subgroups [spontaneous preterm labour, preterm premature rupture of membranes, medically induced preterm delivery, moderate preterm delivery (gestational age at delivery 34-36 weeks) and very preterm delivery (gestational age at delivery <34 weeks)] were compared with 424 randomly selected women who delivered at term. Maternal ferritin concentrations, measured in serum collected at 17 weeks gestation on average, was determined using a two-site chemiluminometric immunoassay. Using multiple logistic regression, we derived maximum likelihood estimates of adjusted odds ratios (OR) and 95% confidence intervals [CI]. Elevation in maternal second-trimester ferritin was weakly associated with the risk of preterm delivery overall. After adjusting for possible confounding by maternal age, race/ethnicity, parity, Medicaid payment status and smoking during the index pregnancy, the OR for extreme quartiles (>64.5 vs. <26.0 ng/mL) of ferritin was 1.3 [95% CI 0.8, 2.1]. Stratified analyses indicated that elevated maternal serum ferritin was associated with an increased risk of preterm premature rupture of membranes (OR = 2.1; 95% CI 1.1, 4.1), but not with spontaneous preterm labour (OR = 0.9; 95% CI 0.4, 1.7) or medically induced preterm delivery (OR = 1.1; 95% CI 0.6, 2.0). The relationship between elevated maternal second-trimester serum ferritin concentrations and preterm delivery was strongest for spontaneous very preterm deliveries (<34 weeks gestation). Women with ferritin concentrations in the highest decile (>96 ng/mL) experienced a 2.7-fold increased risk of delivering before 34 completed weeks, compared with women with concentrations <26.0 ng/mL. These results are consistent with some previous reports, and further underline the potential for heterogeneity in the aetiology of preterm delivery.

The effect of maternal anemia and iron deficiency on fetal erythropoiesis: comparison between serum erythropoietin, hemoglobin and ferritin levels in mothers and newborns

Objective: Maternal and fetal serum erythropoietin levels were correlated with hemoglobin, mean corpuscular volume and serum ferritin in a group of anemic pregnant women to evaluate the effect of maternal anemia on fetal erythropoiesis. Methods: Serum erythropoietin, ferritin, hemoglobin and mean corpuscular volume were investigated in 33 pregnant women with anemia, 11 women with normal hematological parameters and in their newborns. Results: Maternal serum erythropoietin concentration (mean ± SEM) was significantly higher in the anemic group (145.2 ± 42.9 mU/ml) as compared to the control group (37.3 ± 7.6 mU/ml) (p < 0.05). In newborns, all parameters were comparable in both groups except cord serum erythropoietin concentration (mean ± SEM) which was significantly higher in newborns born to anemic women (43.9 ± 5.3 mU/ml) than controls (29.4 ± 3.7 mU/ml) (p < 0.05). In the anemic group, maternal serum erythropoietin was inversely correlated to maternal hemoglobin (r = -0.375, p = 0.03), maternal hemoglobin was inversely correlated to cord serum erythropoietin (r = -0.552, p = 0.001) and maternal ferritin was correlated to fetal ferritin (r = 0.521, p = 0.002). Conclusion: Although cord hemoglobin and mean corpuscular volume were not affected by maternal anemia, increased cord serum erythropoietin levels related to low maternal hemoglobin levels suggest an induced fetal erythropoiesis in maternal anemia.

Third trimester iron status and pregnancy outcome in non-anaemic women; pregnancy unfavourably affected by maternal iron excess.

A prospective observational study was performed on 488 women with haemoglobin >/=10 g/dl at booking to examine the relationship between serum ferritin concentration quartiles at 28-30 weeks gestation with maternal characteristics, pregnancy complications and infant outcome. While there was no difference in the maternal characteristics or gestational age, the infant size decreased significantly and progressively from the lowest to the highest quartile. Despite a significant difference in the incidence of multiparous women, there was no difference in the incidence of most complications except for prelabour rupture of the membranes and infant admission to the neonatal unit. Compared with the other three quartiles, the highest quartile was associated with increased risk for preterm delivery and neonatal asphyxia, while the lowest quartile was associated with decreased risk of pre-eclampsia, prelabour rupture of the membranes, and infant admission to the neonatal unit. Overall, ferritin quartiles were correlated with other parameters of iron status and red cell indices, and ferritin concentration was inversely correlated with infant birthweight. Our findings suggested that maternal ferritin concentration is primarily a reflection of maternal iron status, and a high level is associated with unfavourable outcome. The rationale of routine iron supplementation in non-anaemic women needs to be re-examined.

Hemoglobin and Red Cell Indices Correlated With Serum Ferritin Concentration in Late Pregnancy

In Brief Objective To study the correlation between third-trimester serum ferritin concentration and hemoglobin and red cell indices to select the best hematologic characteristic to identify women who need iron therapy. Methods In a prospective study, blood was drawn from pregnant women with hemoglobin above 10 g/dL, and thalassemia trait excluded at booking, at 28–30 weeks' gestation to study the correlation (Spearman ρ value) between serum ferritin concentration and hemoglobin level, mean corpuscular volume, mean cell hemoglobin, mean cell hemoglobin concentration, and hematocrit. The best relationship was identified using receiver operating characteristic (ROC) curves. Results Serum ferritin concentration correlated significantly with hemoglobin (ρ = .211), mean corpuscular volume (ρ = .332), mean cell hemoglobin (ρ = .304), and hematocrit (ρ = .199). The area under the ROC curve was largest for hemoglobin. Conclusion Serum ferritin concentration at the early third trimester correlated best with hemoglobin level. If a hemoglobin level of 11 g/dL or below (25% of all patients) was used as the cutoff, 64% of women who needed iron therapy were identified. Maternal ferritin concentrations at 28–30 weeks' gestation correlate best with hemoglobin levels and identify pregnant women who need iron therapy.

The influence of maternal nutritional factors on intrauterine growth retardation in Brazil.

A case-control study of 712 Brazilian mother-baby pairs was performed to assess maternal nutritional factors, more specifically low or marginal concentrations of vitamin A, folate and iron, as risk factors for intrauterine growth retardation (IUGR). Newborns were classified as being IUGR according to the Lubchenco classification. The gestational age of the newborns was evaluated by the Capurro method. Vitamin A, folate, ferritin and haemoglobin were measured by high-performance liquid chromatography, radioimmunoassay, immunoenzymetric assay and by the cyanmethaemoglobin method respectively. The relationship between maternal nutritional status and IUGR was investigated using stratification and logistic regression. According to the final logistic regression model, the risk factors for IUGR were: maternal body weight, per capita income, cigarette smoking, maternal weight gain, prior history of low birthweight, high maternal ferritin, beer intake and coffee intake. Specific interventions likely to have the major short-term impact in this region are not directly related to nutritional factors, but to efforts to reduce or eliminate toxic exposures. Over the long term, improvement in maternal nutritional status and socioeconomic conditions would be expected to produce important benefits.

The influence of maternal iron deficiency anaemia on the haemoglobin concentration of the infant.

Serum ferritin, iron, and haemoglobin (Hb) values of 27 pregnant women who did not receive oral iron therapy during pregnancy, and Hb of their normal full-term babies were determined. Maternal blood samples were obtained at 16 and 24 weeks of pregnancy and infants' blood samples were obtained at the first day and 3 months of life. Mothers were divided into two groups according to their serum ferritin values. By analysing the results we were not able to detect any correlation between maternal ferritin, Hb, and newborn gestational age, and Hb and birth weight. The same was found when the groups were compared by a maternal serum ferritin above and below 12 ng/ml.

Serum ferritin and cobalamin in growth retarded fetuses

To examine fetal and maternal serum cobalamin and ferritin concentrations in pregnancies complicated by fetal growth retardation. Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London. Cross sectional study. Fetal blood samples obtained by cordocentesis from 20 growth retarded fetuses at 26 to 36 weeks of gestation. Maternal venous blood was also collected and serum ferritin and cobalamin concentrations were measured by radio-immunoassay in the fetal and maternal samples. In the growth retarded group, the mean fetal serum concentration of cobalamin was higher than the normal mean for gestation (t = 3.27, P < 0.01), and this increase was significantly associated with fetal acidaemia (r = -0.686, P < 0.001) and erythroblastosis (r = 0.731, P < 0.001). In contrast, the fetal to maternal ferritin ratio was significantly reduced; there was a nonsignificant decrease in fetal serum and an increase in maternal serum ferritin concentration. There was an association between fetal serum ferritin concentration and erythrocyte count (r = -0.612, P < 0.01). In placental insufficiency, as in postnatal starvation and Kwashiorkor syndrome, uptake and storage of cobalamin by the fetal liver may be impaired. The decrease in fetal to maternal ratio of ferritin could be the consequence of impaired placental perfusion.

Maternal Ferritin Values and Foetal Iron Stores

Acta PaediatricaVolume 79, Issue 4 p. 467-467 Maternal Ferritin Values and Foetal Iron Stores M. B. Krawinkel, Corresponding Author M. B. KrawinkelDr Michael B. Krawinkel, Universitätskinderklinik, Schwanenweg 20, D-2300 Kiel 1, FRGSearch for more papers by this authorM. Bethge, M. BethgeSearch for more papers by this authorA. O. El Karib, A. O. El KaribSearch for more papers by this authorH. M. Ahmet, H. M. AhmetSearch for more papers by this authorO. A. Mirghani, O. A. MirghaniSearch for more papers by this author M. B. Krawinkel, Corresponding Author M. B. KrawinkelDr Michael B. Krawinkel, Universitätskinderklinik, Schwanenweg 20, D-2300 Kiel 1, FRGSearch for more papers by this authorM. Bethge, M. BethgeSearch for more papers by this authorA. O. El Karib, A. O. El KaribSearch for more papers by this authorH. M. Ahmet, H. M. AhmetSearch for more papers by this authorO. A. Mirghani, O. A. MirghaniSearch for more papers by this author First published: April 1990 https://doi.org/10.1111/j.1651-2227.1990.tb11495.xCitations: 7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume79, Issue4April 1990Pages 467-467 RelatedInformation

Serial serum ferritin and other hematological parameters in normal Nigerian primigravidae

Serial hematological indices using Coulter Counter and serum ferritin using radioimmunoassay techniques were determined in 20 healthy Nigerian primigravidae with hemoglobin genotype AA. PCV fell significantly (P < 0.001) to a minimum value at 28 weeks that was 6% lower than the mean value at 8 weeks postpartum. PCV at 36 weeks was still significantly (P < 0.001) lower than the post partum value. There was an insignificant but progressive increase in MCV values throughout pregnancy. Changes in MCH and MCHC were insignificant. Ferritin levels in both the non-pregnant and pregnant subjects were high and probably reflected the high iron content of Nigerian foods. Though the cord serum ferritin level was significantly higher (P < 0.001) than maternal ferritin at delivery there was no significant correlation between the two.

Fetal lead exposure: Antenatal factors

It was hypothesized that maternal blood lead level at delivery and cord blood lead level of the neonate would be affected by maternal use of alcohol, history of alcohol abuse, and smoking. The possibility that iron status, as reflected in maternal serum ferritin, would be related to lead level was also explored. The maternal history of alcohol abuse was unrelated to lead level in 208 samples of maternal blood and 178 samples of cord blood. However, alcohol use during pregnancy was related in a dose-response fashion to maternal and to cord blood lead level. This effect was significant with and without control of maternal smoking. The effect of maternal smoking and serum thiocyanate on maternal and cord blood lead level were also highly significant with and without control of the maternal drinking variable. Serum ferritin was marginally related to lead level for white women and for black infants, but tests of the dichotomized maternal ferritin variable did not yield a significant linkage with maternal or cord blood lead level. The results further support recommendations that women abstain from alcohol consumption and cigarette smoking in pregnancy.

Free erythrocyte protoporphyrin as an index of perinatal iron status.

The relationship between free erythrocyte protoporphyrin and conventional indices of iron status was studied in 49 mothers and their infants. Maternal venous blood samples were collected at 34 weeks gestation and at delivery. The corresponding infant blood samples were collected from the umbilical cord and at age 6 weeks. In each case free erythrocyte protoporphyrin, serum iron, total iron binding capacity, and serum ferritin were determined. Cord free erythrocyte protoporphyrin was negatively correlated with maternal ferritin at 34 weeks gestation (p = 0.016) and at delivery (p = 0.014), and with transferrin saturation at delivery (p = 0.026). The infants' haemoglobin concentrations at 6 weeks were significantly negatively related to maternal free erythrocyte protoporphyrin at 34 weeks (p = 0.026) and at delivery (p = 0.026). Cord free erythrocyte protoporphyrin is an index of maternal iron status in the last trimester. Maternal free erythrocyte protoporphyrin in the last trimester predicts the magnitude of physiological anaemia of the infant at age 6 weeks.

Free Erythrocyte Protoporphyrin as an Index of Perinatal Iron Status

The relationship between free erythrocyte protoporphyrin and conventional indices of iron status was studied in 49 mothers and their infants. Maternal venous blood samples were collected at 34 weeks gestation and at delivery. The corresponding infant blood samples were collected from the umbilical cord and at age 6 weeks. In each case free erythrocyte protoporphyrin, serum iron, total iron binding capacity, and serum ferritin were determined. Cord free erythrocyte protoporphyrin was negatively correlated with maternal ferritin at 34 weeks gestation (p = 0.016) and at delivery (p = 0.014), and with transferrin saturation at delivery (p = 0.026). The infants' haemoglobin concentrations at 6 weeks were significantly negatively related to maternal free erythrocyte protoporphyrin at 34 weeks (p = 0.026) and at delivery (p = 0.026). Cord free erythrocyte protoporphyrin is an index of maternal iron status in the last trimester. Maternal free erythrocyte protoporphyrin in the last trimester predicts the magnitude of physiological anaemia of the infant at age 6 weeks.