Maternal Iron Deficiency Anemia Research Articles

How does maternal anemia affect the levels of umbilical cord brain-derived neurotrophic factor?

ObjectiveIn this study, we aimed to evaluate the effect of maternal iron deficiency anemia on the umbilical cord level of brain-derived neurotrophic factor (BDNF), which plays a very important role in the central nervous system. MethodsOur research was planned as a quantitative, prospective, and analytical type of study. A total of 90 volunteers, term, singleton pregnant hospitalized in the Health Sciences University Ümraniye Training and Research Hospital Gynecology and Obstetrics Clinic between September 2021 and August 2022 were included in this study. While 45 of these pregnants were pregnant women with iron deficiency anemia (hemoglobin ≤ 110 g/L and serum ferritin level ≤ 12 μg/L), 45 cases were in the control group without iron deficiency anemia (hemoglobin > 110 g/L, serum ferritin > 12 μg/L). When pregnant were admitted to the hospital, blood samples were taken to analyze hemoglobin, mean cell volume (MCV), iron, unsaturated iron binding capacity, total iron binding capacity, serum ferritin, transferrin, and CRP levels. Also, we noted the maternal age, gravida, parity, birth weight, head circumference, type of birth, 1. minute Apgar score, and 5. minute Apgar score. During the delivery; after the umbilical cord had been clamped and cut, we took 5 cc of umbilical cord blood. Then, we put it in the serum-separating laboratory tubes. After we centrifuged these blood samples, we put the serum parts in the Eppendorf tubes to be stored at −80 degrees Celsius. At the end of the study, we calculated the level of BDNF using special human brain-derived neurotrophic factor ELISA kits. The umbilical cord BDNF levels of the maternal iron deficiency anemia group and the control group were compared statistically. ResultsWhen we evaluated the fetal umbilical cord BDNF values of 90 participants, the median value BDNF in the babies of 45 anemic mothers was 3.16 (IQR 0.73), and the median BDNF value of the babies of 45 healthy mothers was 5.37 (IQR 1.02). We found a statistical difference between BDNF and hemoglobin, hematocrit, MCV, and iron values between these two groups. ConclusionIn conclusion, the BDNF value of the babies of healthy individuals is higher than that of anemic individuals. Our study showed that the amount of BDNF in the umbilical cord blood was significantly affected by maternal iron deficiency anemia.

Assessment of fetal cardiac functions in pregnant women with anemia: prospective, case-control study.

To compare the fetal cardiac functions between pregnant women with iron deficiency anemia (IDA) and healthy controls. This single-center, prospective, case-control study was conducted at a tertiary hospital. A total of 150 patients, including 50 patients with IDA and 100 healthy pregnant women at 30-34 weeks of gestation, were included in the study. Of the patients with anemia, 20 had mild anemia, 18 had moderate anemia, and 12 had severe anemia. Pulsed-wave Doppler, M-mode, and tissue Doppler imaging (TDI) were performed to evaluate fetal cardiac functions. The fetal cardiac score was calculated using the systolic, diastolic, and global hemodynamic function parameters. The myocardial performance index and isovolumetric relaxation time were significantly higher in the IDA group than the control group, while isovolumetric contraction time was similar. Among the tricuspid and mitral valve diastolic parameters, the E, A, and E/A values were significantly lower in the IDA group (p<0.001). Mitral and tricuspid annular plane systolic excursions (MAPSE and TAPSE, respectively) were significantly lower in the IDA group (p<0.001). The IDA group also had significantly lower values for the TDI parameters, mitral and tricuspid E', A', S', E'/A' and a significantly higher E/E' ratio (p<0.001). Upon examination of anemia subgroups, a significant decrease was observed in the tricuspid and mitral A, E, and E/A in those with severe anemia (p<0.001). M-mode Doppler analysis revealed significantly lower TAPSE and MAPSE in the patient group with severe anemia. According to the subgroup comparison of TDI findings, the patients with severe anemia had significantly lower tricuspid and mitral E', A', S' and E'/A' (p<0.001) values and a significantly higher E/E' ratio (p<0.001). The fetal cardiac score was significantly higher in the maternal IDA group compared to the control group. A significant negative correlation was found between maternal hemoglobin level and fetal cardiac score (p<0.001). There may be changes in the systolic and diastolic cardiac functions of the fetuses of pregnant women with IDA. This study showed an increased E/E' ratio in the fetuses of pregnant women with IDA, suggesting a decrease in fetal heart maturation. Within the IDA group, fetal cardiac functions were more affected in those with severe anemia. This article is protected by copyright. All rights reserved.

Age and sex-based impacts of maternal iron deficiency on offspring's cognitive function and anemia: A systematic review.

Iron deficiency is a recognized global health concern, particularly impactful during pregnancy where the mother serves as the primary source of iron for the developing fetus. Adequate maternal iron levels are crucial for fetal growth and cognitive development. This review investigates the correlation between maternal iron deficiency and cognitive impairment and anemia in offspring, considering age and gender differentials. PubMed, ScienceDirect, and Google Scholar databases were queried using keywords "maternal," "iron," "gender/sex," and "cognition." The review included studies on human and animal subjects where maternal iron deficiency was the exposure and offspring cognitive function and anemia were outcomes. Out of 1139 articles screened, fourteen met inclusion criteria. Twelve studies highlighted cognitive deficits in offspring of iron-deficient mothers, with females generally exhibiting milder impairment compared to males. Additionally, two studies noted increased anemia prevalence in offspring of iron-deficient mothers, particularly affecting males and younger individuals. The findings suggest that male offspring are at higher risk of both anemia and cognitive dysfunction during youth, while females face increased risks in adulthood. Thus, maternal iron deficiency elevates the likelihood of anemia and cognitive impairments in offspring, underscoring the importance of addressing maternal iron status for optimal child health.

Current research and evidence gaps on placental development in iron deficiency anemia.

Studying the effects of maternal iron deficiency anemia (IDA) is complex owing to its diverse causes, each independently impacting the placenta and fetus. Simple treatment with iron supplements does not always resolve the anemia. Therefore, delving into how IDA alters placental development at a molecular level is crucial to further optimize treatment. This review addresses the effects of IDA on placental structures and functions, including changes in oxygen levels, blood vessels, and the immune system. Profound understanding of physiological characteristics and regulatory mechanisms of placental development is key to explain the mechanisms of abnormal placental development in pregnancy-associated disorders. In turn, future strategies for the prevention and treatment of pregnancy complications involving the placenta can be devised. These studies are significant for improving human reproductive health, enhancing sociodemographic qualities, and even lifelong wellbeing, a focal point in future placental research.

Prevalence and correlates of childhood anemia in the MINA-Brazil birth cohort study.

This study aimed to describe the prevalence and predictors of childhood anemia in an Amazonian population-based birth cohort study. Prevalence of maternal anemia was estimated at delivery (hemoglobin [Hb] concentration < 110 g/L) in women participating in the MINA-Brazil birth cohort study and in their children, examined at ages one, two (Hb < 110 g/L), and five (Hb < 115 g/L). Moreover, ferritin, soluble transferrin receptor, and C-reactive protein concentrations were measured in mothers at delivery and in their 1- and 2-year-old children to estimate the prevalence of iron deficiency and its contribution to anemia, while adjusting for potential confounders by multiple Poisson regression analysis (adjusted relative risk [RRa]). The prevalence 95% confidence interval (CI) of maternal anemia, iron deficiency, and iron-deficiency anemia at delivery were 17.3% (14.0-21.0%), 42.6% (38.0-47.2%), and 8.7% (6.3-11.6)%, respectively (n = 462). At one year of age (n = 646), 42.2% (38.7-45.8%) of the study children were anemic, 38.4% (34.6-42.3%) were iron-deficient, and 26.3 (23.0-29.9) had iron-deficiency anemia. At two years of age (n = 761), these values decreased to 12.8% (10.6-15.2%), 18.1% (15.5-21.1%), and 4.1% (2.8-5.7%), respectively; at five years of age (n = 655), 5.2% (3.6-7.2%) were anemic. Iron deficiency (RRa = 2.19; 95%CI: 1.84-2.60) and consumption of ultra-processed foods (UPF) (RRa = 1.56; 95%CI: 1.14-2.13) were significant contributors to anemia at 1 year, after adjusting for maternal schooling. At 2 years, anemia was significantly associated with maternal anemia at delivery (RRa: 1.67; 95%CI: 1.17-2.39), malaria since birth (2.25; 1.30-3.87), and iron deficiency (2.15; 1.47-3.15), after adjusting for children's age and household wealth index. Anemia continues to be highly prevalent during pregnancy and early childhood in the Amazon. Public health policies should address iron deficiency, UPF intake, maternal anemia, and malaria to prevent and treat anemia in Amazonian children.

Iron Deficiency in Young Children Beyond Anemia: Clinical Features, Maternal Factors, and the Predictor for Neuropsychomotor Development Delay

Introduction: Iron deficiency (ID) is the most common micronutrient deficiency in children and is prevalent in young children, especially in those with long-term exclusive breastfeeding (BF). Iron deficiency anemia (IDA), the most common type of pediatric anemia, while it is not the only clinical manifestation of ID. In Taiwan, prevalence of IDA was up to 23% in child-bearing women. It was reported that the iron levels in the breast milk of IDA mothers were markedly lower than that of non-IDA mothers. ID alone in young children can cause neurocognitive development symptoms, including inattention, psychomotor delay, cognition impairment, pica, etc, in children. However, clinical reports on ID, not IDA, are relatively few. We aimed to investigate the clinical features and influencing factors of ID in young children. Methods and Materials: There were 33 young children diagnosed as ID at outpatient department at Taipei Medical University Hospital from 2017 to 2019. The charts were retrospectively reviewed and clinical data were collected, including diagnostic age, initial symptoms, periods of breast-feeding (BF), hemoglobin (Hb), mean corpuscular volume (MCV), serum ferritin (SF), serum iron, total iron binding capacity (TIBC), zinc levels, thalassemia survey, duration of iron supplement, and laboratory improvement after iron supplement. Whether there were neuropsychomotor (NPMD) delay depended on the chart record of doctors of pediatric rehabilitation. Results: The median age of ID diagnosis was 2.5 years (range: 5 month－7.17 years). There were 31 (94%) of ID children initially presented with either koilonychias, picky eating, or poor appetite. 24 (72.7%) were found to have koilonychias, and among them, 18 (54.5%) had flat nails and 6 (18.2%) had spoon nails. 17 (51.5%) were picky eaters, 16 (48.5%) had poor appetite, 7 (21.2%) had pale nails, and 3 (9.1%) had pica. 11 (33.3%) had NPMD delay. The median duration of BF was 10.8 months (range: 0 to 36). There were 12 (36.4%) children whose mother had IDA. The median Hb was 11.2 g/dL (IQR: 10－12.65), median MCV was 76.45 fL, median SF level was 25 ng/mL (IQR: 13.25－45.5), and median transferrin saturation was 9.25% (IQR: 7－12.88). The median serum zinc level at diagnosis of ID was 66.4 μg/dL. In addition, 21 (63.6%) has concurrent zinc deficiency, 10 (30.3%) had pediatric IDA, and 2 (6.3%) had combined thalassemia trait. The median (IQR) duration of iron supplement is 3 (3-6) months. After treatment, patients' data revealed a significant increase in median Hb of 12.6 mg/dL, median MCV of 78.7 fL, median SF of 47 ng/mL, and median transferrin saturation of 15.35%. By correlation analysis, breastfeeding duration was also moderately correlated to SF level (Pearson rank=-0.5224). Maternal IDA history also had a negative correlation to SF level in ID children (Pearson rank=-0.4053). By multivariate linear regression (MVLR) analysis, breastfeeding duration and maternal IDA history were identified as significantly inverse predictors for SF levels in ID children. ID children with NPMD delay had significantly higher rate of concurrent zinc deficiency. By MVLR analysis, serum zinc level was identified as a significant inverse predictor for NPMD delay among ID children (Odd's ratio: 0.89, 95%CI: 0.799-0.991, p-value=0.0336*). Conclusion: Our results highlighted the clinical features of ID in infants and children. A high proportion of ID children had maternal IDA history (36.4%) and NPMD delay (33.3%). Iron supplementary was effective to improve ID. Breastfeeding duration and maternal IDA history can negatively impact SF level in ID children. Good levels of serum zinc in ID children can predict lower risk of NPMD delay. Disclosures : No relevant conflicts of interest to declare.

The role of gestational weight gain rate in the development of maternal iron deficiency anaemia

Aims: Our aim is to analyze the effect of weight gain rates on the development of anaemia in a homogeneous group of pregnant women taking similar nutritional supplements in our own society and to emphasize the importance of weight control based on this hypothesis. Methods: The study was conducted retrospectively with 127 pregnant women between 20 and 40 years old. Pregnant women in normal weight and having body mass index (BMI) between 18.5 and 24.9 were included in the study. These women were divided into two groups according to the amount of weight they gained during pregnancy: those who weighed less than 11 kg and those who gained 11 kg or more. Ages of patients, number of pregnancies and births, 1st and 3rd trimester weights, 1st and 3rd trimester weight differences, 1st and 3rd trimester hemoglobin (Hgb), hematocrit (Hct), mean corpuscular volume (MCV) measurements were recorded. The correlation of changes between weight gain and blood parameters was evaluated. Results: No statistically significant change was observed between the 1st and 3rd trimester Hgb and Hct averages of pregnant women who gained less than 11 kg during pregnancy. 3rd Trimester Hgb, Hct averages of the pregnant group who gained 11 kg or more were found to be statistically significantly lower than the outset Hgb, Hct averages (p=0.001, p=0.001). No statistically significant difference was observed between the 1st Trimester and 3rd Trimester MCV averages of the &lt;11 kg difference and &gt;11 kg difference groups (p=0.271, p=0.183). No statistically significant difference was observed between the 1st trimester ferritin averages of the &lt;11 kg difference and &gt;11 kg difference groups (p = 0.055). 3rd trimester ferritin averages of the &gt;11 kg difference group were found to be statistically significantly lower than the &lt;11 kg difference group (p =0.016). Conclusion: As a result of our study, we can say that rapid weight gain during pregnancy deepens anaemia. Randomized studies continue to be the best source of evidence in testing hypotheses mentioning that early use of iron supplements and strengthening weight control may reduce the risk of IDA.

Pregnancy Complications and Their Relationship with Neonatal Complications in Mothers Referring to Healthcare Centers in South East of Iran

Background: Some adverse pregnancy outcomes are rooted in the gestation period and can influence the mother, newborn, or both. This study aimed to investigate the prevalence of pregnancy complications and their relationship with neonatal complications in mothers referring to the healthcare centers in Zahedan, Iran. Methods: This cross-sectional study was conducted on 630 women referring to the health care centers in Zahedan selected using systematic random sampling. Demographic information and anthropometric indices were collected and recorded in gestational and neonatal care forms. The data were analyzed in SPSS v. 22 using the chi-square test. Results: The results revealed that 18.9% of the mothers had anemia, 12.7% gestational diabetes mellitus (GDM), 5.1% thyroid disorders, 4% hypertension, and 2.1% preeclampsia. Moreover, 14.1%, 41.1%, and 22.7% of the mothers were underweight, overweight, and obese, respectively. A significant relationship existed between the infant's birth weight and the mother's body mass index, hypertension, GDM, and maternal iron deficiency anemia (P &lt; 0.05). Infant jaundice was also significantly related to GDM and preeclampsia (P &lt; 0.05). Conclusions: Identifying problems threatening the health of mothers and newborns and paying more attention to nutritional health care during pregnancy are efficient strategies for preventing and controlling pregnancy-related neonatal complications and the health of mothers and newborns. Specific attention to prevention programs, strengthening health care policies during pregnancy, and promoting prenatal care and self-care are major health priorities.

Iron supplements in pregnant women with normal iron status: A systematic review and meta-analysis.

Effects of daily iron supplementation in iron replete pregnancy are unclear. This systematic review aimed to assess benefits and harms of oral iron supplements in pregnant women without anemia and iron deficiency. We predefined and registered a protocol in PROSPERO (CRD42020186210) and performed the review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We searched for randomized clinical trials (RCTs) and observational studies comparing daily oral iron supplementation with no iron supplements in non-anemic iron replete pregnant women. Searches were conducted in MEDLINE (by PubMed), EMBASE (by OVID), Cochrane Library, and ClinicalTrials.gov from inception to September 2022 without language restrictions. Two authors independently screened records, extracted data, and assessed risk of bias using the revised Cochrane risk of bias tool (RoB2). One author read full-texts, assessed certainty of evidence by GRADE and conducted meta-analyses using a random-effects model. Primary outcomes included iron deficiency anemia, iron deficiency, hemoglobin >130 g/L, elevated iron status, small for gestational age newborns, low birthweight newborns, preterm birth, and congenital anomalies. Eight RCTs (2822 women) but no observational studies were eligible for inclusion. Daily oral iron supplementation in pregnancy probably reduces iron deficiency anemia at term (risk ratio [RR]: 0.51, 95% confidence interval [CI]: 0.38-0.70; 4 RCTs, 1670 women; I2 = 13%; moderate-certainty evidence) and the incidence of low birthweight babies (RR: 0.30, 95% CI: 0.13-0.68; 2 RCTs, 361 infants; I2 = 0%; moderate-certainty evidence). In addition, it may reduce iron deficiency at term (RR: 0.74, 95% CI: 0.60-0.92; 4 RCTs, 1663 women; I2 = 58%; low-certainty evidence) and the incidence of small for gestational age babies (RR: 0.39, 95% CI: 0.17-0.86; 1 RCT, 213 infants; I2 not estimable; low-certainty evidence). Daily iron supplementation in iron replete non-anemic pregnant women probably reduces the risk of maternal iron deficiency anemia at term and low birthweight.

Distortion product otoacoustic emissions in newborn babies with and without late-term maternal iron deficiency anaemia

BackgroundStudies on animals have demonstrated that maternal iron deficiency anaemia (IDA) could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions (DPOAEs) of young guinea pigs. Thus, it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA. The current study explores maternal IDA's effect on DPOAEs in newborn babies. MethodA total of 110 newborn babies with gestational age ≥34 weeks were considered and a ‘between-subjects’ design was used. The participants were divided into 3 groups- “Normal” (61 babies without maternal IDA), “Mild” (28 babies with mild maternal IDA) and “Moderate” (21 babies with moderate maternal IDA). The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies (1 k – 8 kHz) and a range of intensities (70–40 dB SPL in 10 dB steps). ResultsThe analysis of both DP-gram and DP input-output (I/O) function showed that there was no significant difference (p > 0.05) across the normal, mild, and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities (70–40 dB SPL). Also, the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship. ConclusionThe current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

Effects of Iron Deficiency Anaemia in Pregnancy Outcome: A Single-Center Study

Background: Maternal anaemia especially iron deficiency anaemia has become a common problem worldwide. It is associated with adverse pregnancy outcomes like preterm birth, low birth weight and increases incidence of postpartum haemorrhage (PPH). Hence, this study aimed to find the association between maternal iron deficiency anaemia and pregnancy outcome. Methods: This retrospective cross-sectional study was conducted at the department of Obstetrics and Gynaecology in Kumudini Women's Medical College, Tangail, Bangladesh. The study was conducted during the period of July 2019-January 2020. A total of 93 pregnant women were found to be anemic through this whole trial. Result: In this study, 52% patients had mild level anaemia, 32% had moderate and 16% had severe anaemia. Patients who had severe anaemia significantly suffered from preeclampsia (46.7%), PPH (26.7%), need a blood transfusion during/within 24 hours of delivery (100%), prolonged labor (53.3%), fetal distress (53.3%), placenta praevia (86.7%), low birth weight (86.7%), preterm delivery (40.0%), stillbirth (13.3%) and early neonatal death (within 24 hours) (13.3%). All the complications were strongly associated with severity of anaemia (p value=0.000) except prolonged labour (p-value=0.04). Conclusion: This study concludes that iron deficiency anaemia has significant impact on pregnancy outcome. Hence, iron supplementation can be an effective way for improving IDA among the pregnant anaemic women. Also, proper antenatal care is important so that early detection and treatment of IDA can be possible.

Impact of maternal iron deficiency anemia on fetal iron status and placental iron transporters in human pregnancy

Iron deficiency anemia is associated with maternal morbidity and poor pregnancy outcomes. Heme and non-heme iron transport proteins expressed in the placenta help in adequate iron supply from anemic mother to fetus. Here we examined the expression of placental iron trafficking molecules and their association with maternal and neonatal iron status in pregnant women with iron deficiency anemia (IDA). Pregnant women who received prenatal care at Christian Medical College, Vellore, India for childbirth were recruited. Pregnant women who were 18–35 years old with gestational age (GA) of ≥36 weeks were eligible to participate in the study. In a prospective cohort of pregnant women, 22 % were iron deficiency anemia and 42 % were iron replete. Samples were collected (Maternal blood, placental tissue, and cord blood) from pregnant women with a gestational age of ≥38 weeks at the time of delivery. The mean gestational age at the first visit and delivery was 12.8 ± 2.72 weeks and 39 ± 1.65 weeks, respectively. Hemoglobin (9.3 ± 0.9 g/dl) and ferritin (15.4(0.8–28.3) ng/ml) levels at delivery were significantly decreased in IDA as compared to controls. The fetal hemoglobin and ferritin levels were in the normal range in both groups. There was no correlation between maternal and cord blood hepcidin with fetal iron status in IDA. We further analyzed the expression of iron transport genes in the placenta of controls and the IDA group. Under maternal iron insufficiency, the expression of placental iron transporters DMT1, FPN1, and GDF15 was upregulated at the protein level. In IDA, placental GDF15 and ferroportin protein had an association with fetal iron status. These findings confirm that placental iron traffickers respond to maternal iron deficiency by increasing their expression and allowing sufficient iron to pass to the fetus.

Improving Iron and Folic Acid Supplementation Among Pregnant Women: An Implementation Science Approach in East-Central Uganda.

To address maternal iron-deficiency anemia and low uptake of iron and folic acid supplementation (IFAS) among antenatal care (ANC) clinic attendees in East-Central Uganda, the Anemia Implementation Science Initiative embedded enhanced quality improvement (QI) activities into an integrated health project utilizing QI methodologies. To address 2 bottlenecks of stock-outs and inadequate health education for pregnant women during ANC, an enhanced QI intervention was implemented from July 2019 to September 2020 in 2 districts. We conducted a mixed-methods effectiveness quasi-experimental study to assess whether the intervention increased the availability of IFAS in the intervention districts. We used longitudinal facility-level data from 2 treatment districts and 1 comparison district for the quantitative results. Difference-in-difference estimation was used to measure the impact of the intervention on IFAS health education and IFA availability at the health facility. We used logistic regression modeling to control for factors associated with IFAS uptake and potential differences in baseline values. Researchers conducted exit interviews with ANC clients and in-depth interviews with providers and district managers for greater insights into the implementation process. The intervention increased the probability, at a statistically significant level, of pregnant women both receiving IFAS and receiving health education on IFAS during ANC. According to inter-viewees, the intervention approach improved stakeholder engagement and buy-in, which brought about change at all levels of the health system. The intervention successfully addressed the 2 main bottlenecks to availability of IFAS for pregnant women attending ANC-inadequate provision of IFAS education and a weak drug quantification process. Even without additional funds to purchase commodities, this approach improved district capacity to advocate for and manage IFAS commodities. It could also be used to strengthen overall ANC quality.

Abstract 13297: Higher Maternal Serum Ferritin in the Third Trimester is Associated With Reduced Endothelial Function in the Preadolescent Child

Introduction: Elevated iron status in pregnancy has been implicated in gestational diabetes (GDM) development and in cardiovascular (CV) disease progression in adults. Animal models, however, have suggested maternal iron deficiency anemia may increase the offspring’s risk of CV disease. Whether maternal iron levels impact the CV health of the child in humans is unknown. This study investigated the relationship between maternal iron markers and the child’s CV health. Methods: This is a nested observational study tied to the Alberta Pregnancy Outcomes and Nutrition (APrON) Study. Children of mothers with and without GDM but otherwise uncomplicated pregnancies were prospectively recruited. Maternal serum ferritin, total iron binding capacity, and hemoglobin in the 2 nd and 3 rd trimesters were obtained. CV outcomes included: left ventricular mass Z-score, reactive hyperemia index score (lnRHI, EndoPAT), Doppler-based aortic and peripheral arterial pulse wave velocity, and carotid intima-media thickness. Univariate and multiple linear regression models, including maternal GDM as a covariate, were built to explore relationships between maternal iron markers and the child’s CV health. Results: Fifty-two children, 40 (77%) female, were assessed at a mean age of 10.9±0.7 years. Maternal serum ferritin in the 2 nd (median (IQR): 38.8 (39.2) ng/mL; B=-0.0039, p=0.01) and 3 rd trimesters (13.7 (9.0); B=-0.011, p=0.008) inversely related to the child’s lnRHI in univariate analyses, whereas no other relationships were observed between maternal iron markers and the child’s CV health. While the effect of 2 nd trimester serum ferritin was attenuated in a multiple linear model adjusting for maternal GDM, another model demonstrated a persistent relationship of 3 rd trimester serum ferritin with lnRHI (B=-0.028, p=0.007), not impacted by maternal GDM (B=-0.37, p=0.11) or their interaction term (B=0.020, p=0.07). Conclusions: High maternal serum ferritin in the 3 rd trimester may be associated with reduced endothelial function of the child. If validated, further work is needed to understand pathogenic mechanisms, and the impact of supplementation guidelines in pregnancy.

Iron deficiency increases the risk of postpartum depression

Background and Objective: Maternal iron deficiency anemia is thought to be related to postpartum depressive in biology pathway. Ferritin is the first test to become abnormal as iron stores decrease and it is not affected by recent iron ingestion. Furthermore, iron deficiency anemia also can decrease Brain Derived Neurotrophic Factor (BDNF) which play role in sinaps plasticity in neuron. The purpose of this study is to determinate difference of maternal BDNF and total score Edinburgh Postnatal Depression Scale (EPDS) between low and normal ferritin among pregnant women. Methods and Study Design: This was an observational study with a cross-sectional design at Health Center Care Lubuk Buaya Padang and Biomedical Laboratory Faculty of Medicine Andalas University in Indonesia in November 2016 to June 2017. Samples in this study are 72 pregnant women in 37 until 42 weeks pregnancy were divided to 2 groups which are low (&lt; 12 ng/mL) and normal ferritin (≥ 12 ng/mL). Ferritin and BDNF measured with ELISA after examination and EPDS were assessed at 2 weeks after delivery. Data analysed using independent t test.

Human milk lactoferrin variation in relation to maternal inflammation and iron deficiency in northern Kenya.

Milk lactoferrin is a multi-functional, iron-binding glycoprotein with immunomodulatory effects, protecting infants against infectious diseases. This study explored how maternal inflammation/infection and iron-deficiency anemia (IDA) might influence human milk lactoferrin. Lactoferrin might be elevated with maternal inflammation resulting from infectious disease processes. Conversely, lactoferrin might decrease with IDA, corresponding to scarce maternal iron for transfer in milk. In these two hypothesized scenarios, the degree of lactoferrin elevation or decrease might vary with infant vulnerability to infectious diseases or malnutrition. Alternatively, lactoferrin might be unassociated with inflammation/infection or IDA if mothers could buffer it against these conditions. We used cross-sectional data from Ariaal mothers of northern Kenya (n= 200) to evaluate associations between milk lactoferrin and maternal inflammation/infection, IDA, infant age/sex, and the mother-infant variable interactions in multivariate regression models. Maternal inflammation was associated with higher lactoferrin for younger infants (<~5months of age) but with lower lactoferrin for older infants. Maternal IDA was unassociated with lactoferrin alone or in interaction with infant variables. Results suggest that mothers of vulnerable young infants deliver more lactoferrin when they have inflammation/infection but mothers with older infants do not, and that maternal delivery of lactoferrin is unaffected by their IDA.Longitudinal research should verify these findings.

Highlights from the International Twins Congress 2021

Highlights from the International Twins Congress 2021

Maternal nutritional awareness and iron deficiency anemia in children aged 6 months–2 years in a tertiary care hospital in Coimbatore, Tamil Nadu

Objective: This study aims to analyze the risk factors and vital role of mothers in prevention of nutritional anemia in the early childhood. Methods: A hospital-based cross-sectional study done in Coimbatore for 2 years. Using a pre-tested structured validated tool, mothers of children aged 6 months–2 years were interviewed to collect information on factors contributing to anemia with special regard to maternal knowledge. Results: Anemia was more in the latter half of infancy (67.2%) with male predominance (60.5%). An affirmative association between increased cow’s milk intake and low hemoglobin was present (p=0.002). Employed and less educated mothers had more anemic children (p&lt;0.05). Of 16% mothers classified as “poor” awareness, 95.45% children had low hemoglobin (p&lt;0.05). Conclusion: Recognizing the causative factors plays an essential role in preventing iron deficiency anemia (IDA). Exclusive breastfeeding must be promoted, along with avoiding excessive cow’s milk intake. Intervening at the right period with age-appropriate foods becomes a necessity. Maternal illiteracy has a positive correlation with anemia in infants. Improving maternal awareness by the physicians will pave the road toward a nation free from anemia.

Maternal iron deficiency anaemia in pregnancy: Lessons from a national audit.

We describe the management and the prevalence of iron deficiency anaemia (IDA) during pregnancy by comparison to standards. A cross-sectional national cohort study of women who had given birth six weeks prior to data collection was conducted at maternity units in the UK and Ireland. Participating centres collected data from 10 consecutive pregnant women. Analysis was descriptive to define the prevalence of IDA in pregnancy and the puerperium, and to compare the outcomes in women who had IDA with women who did not have anaemia anytime during pregnancy. Eighty-six maternity units contributed data on 860 pregnancies and births. The overall prevalence of IDA during pregnancy was 30.4% and in the puerperium 20%. Anaemic women were more likely to be from ethnic minorities, odds ratio 2.23 (1.50, 3.32). Adherence to national guidance was suboptimal, and the prevalence of anaemia in pregnancy remains very high. There is pressing need to explore barriers to early identification and effective management of iron deficiency. IDA should be considered a major public health problem in the UK.

Maternal iron stores and its association with newborn iron dynamics and outcomes

Objectives: In pregnant women in developing nations iron deficiency anemia is common. The motherfetus homeostasis may be adversely affected by the demands in pregnancy. This can lead to adverse fetomaternal outcomes like intrauterine growth retardation ,premature delivery, and neonatal and perinatal death. Therefore it is important to understand the relation between maternal and fetal iron handling as this may help in further implementation of measures to prevent iron deficiency in pregnancy and infancy and improve outcomes. Thus, this study was conducted to explore the effect of maternal iron deficiency anemia on newborn iron stores. Methods: The study was conducted in the Department of Obstetrics and Gynecology, Smt. Sucheta Kriplani Hospital, New Delhi, India between November 2014 to March 2016. It was an observational cross sectional study with sample size of 100 antenatal women diagnosed with iron deficiency anemia.We divided the mothers into groups with mild, moderate and severe anemia respectively. The maternal serum ferritin levels were compared with the newborn hemoglobin and serum ferritin levels. Results: Between the three groups the baseline characteristics were comparable. The newborns of mothers with severe anemia had lower Apgar scores and a greater risk of admission. The birth weight did not differ among the groups. The severity of anemia increased with the parity.The cord blood hemoglobin between the groups was comparable, however the cord blood ferritin levels were directly related to maternal hemoglobin values . In those with severe anemia, a positive association was found between maternal ferritin and cord blood hemoglobin and maternal hemoglobin and cord blood serum ferritin. A positive association was also found between maternal hemoglobin and cord blood hemoglobin. Conclusion: The study supports the fact that fetal needs dictate the placental iron demand. With increasing severity of anemia the fetus starts showing decreased serum ferritin and this finally results in iron deficiency at birth. Although the fetal weight and haemoglobin are not compromised with increasing severity of anemia in our study, increased fetal risk manifested by worsening Apgar scores and increased newborn admissions occurred as anemia worsened. This study supports the fact that maternal deficiency of iron affects the newborn iron profile and this reiterates the imperative role of iron supplementation during pregnancy. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 620-625