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Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study

Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study
Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study
Fe deficiency anaemia during early pregnancy has been linked with low birth weight and preterm birth. However, this evidence comes mostly from studies measuring Hb levels rather than specific measures of Fe deficiency. The present study aimed to examine the association between maternal Fe status during the first trimester of pregnancy, as assessed by serum ferritin, transferrin receptor and their ratio, with size at birth and preterm birth. In the Baby VIP (Baby's Vascular health and Iron in Pregnancy) study, we recruited 362 infants and their mothers after delivery in Leeds, UK. Biomarkers were measured in maternal serum samples previously obtained in the first trimester of pregnancy. The cohort included sixty-four (18 %) small for gestational age (SGA) babies. Thirty-three babies were born preterm (9 %; between 34 and 37 weeks). First trimester maternal Fe depletion was associated with a higher risk of SGA (adjusted OR 2·2, 95 % CI 1·1, 4·1). This relationship was attenuated when including early pregnancy Hb in the model, suggesting it as a mediator (adjusted OR 1·6, 95 % CI 0·8, 3·2). For every 10 g/l increase in maternal Hb level in the first half of pregnancy the risk of SGA was reduced by 30 % (adjusted 95 % CI 0, 40 %); levels below 110 g/l were associated with a 3-fold increase in the risk of SGA (95 % CI 1·0, 9·0). There was no evidence of association between maternal Fe depletion and preterm birth (adjusted OR 1·5, 95 % 0·6, 3·8). The present study shows that depleted Fe stores in early pregnancy are associated with higher risk of SGA.
iron, birth weight, preterm birth, pregnancy
0007-1145
1-8
Alwan, Nisreen A.
0d37b320-f325-4ed3-ba51-0fe2866d5382
Cade, Janet E.
8c643623-de48-455e-bec4-dd317207290a
McArdle, Harry J.
a5fce0fb-21ec-4d6c-90f0-80032d5b4561
Greenwood, Darren C.
eb1a8eca-2608-4cd6-baeb-e2ecf8b4cf50
Hayes, Helen E.
ccd2f5d8-f5cb-4150-92d7-e1dff8ff1668
Simpson, Nigel A.B.
f720159e-5eff-4cdd-a315-048079c683af
Alwan, Nisreen A.
0d37b320-f325-4ed3-ba51-0fe2866d5382
Cade, Janet E.
8c643623-de48-455e-bec4-dd317207290a
McArdle, Harry J.
a5fce0fb-21ec-4d6c-90f0-80032d5b4561
Greenwood, Darren C.
eb1a8eca-2608-4cd6-baeb-e2ecf8b4cf50
Hayes, Helen E.
ccd2f5d8-f5cb-4150-92d7-e1dff8ff1668
Simpson, Nigel A.B.
f720159e-5eff-4cdd-a315-048079c683af

Alwan, Nisreen A., Cade, Janet E., McArdle, Harry J., Greenwood, Darren C., Hayes, Helen E. and Simpson, Nigel A.B. (2015) Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study. British Journal of Nutrition, 1-8. (doi:10.1017/S0007114515001166). (PMID:25946517)

Record type: Article

Abstract

Fe deficiency anaemia during early pregnancy has been linked with low birth weight and preterm birth. However, this evidence comes mostly from studies measuring Hb levels rather than specific measures of Fe deficiency. The present study aimed to examine the association between maternal Fe status during the first trimester of pregnancy, as assessed by serum ferritin, transferrin receptor and their ratio, with size at birth and preterm birth. In the Baby VIP (Baby's Vascular health and Iron in Pregnancy) study, we recruited 362 infants and their mothers after delivery in Leeds, UK. Biomarkers were measured in maternal serum samples previously obtained in the first trimester of pregnancy. The cohort included sixty-four (18 %) small for gestational age (SGA) babies. Thirty-three babies were born preterm (9 %; between 34 and 37 weeks). First trimester maternal Fe depletion was associated with a higher risk of SGA (adjusted OR 2·2, 95 % CI 1·1, 4·1). This relationship was attenuated when including early pregnancy Hb in the model, suggesting it as a mediator (adjusted OR 1·6, 95 % CI 0·8, 3·2). For every 10 g/l increase in maternal Hb level in the first half of pregnancy the risk of SGA was reduced by 30 % (adjusted 95 % CI 0, 40 %); levels below 110 g/l were associated with a 3-fold increase in the risk of SGA (95 % CI 1·0, 9·0). There was no evidence of association between maternal Fe depletion and preterm birth (adjusted OR 1·5, 95 % 0·6, 3·8). The present study shows that depleted Fe stores in early pregnancy are associated with higher risk of SGA.

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Accepted/In Press date: 16 March 2015
Published date: 6 May 2015
Keywords: iron, birth weight, preterm birth, pregnancy
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 377208
URI: https://eprints.soton.ac.uk/id/eprint/377208
ISSN: 0007-1145
PURE UUID: 968c87a1-c68f-44a4-96e3-3a744ac03287
ORCID for Nisreen A. Alwan: ORCID iD orcid.org/0000-0002-4134-8463

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Date deposited: 01 Jun 2015 14:35
Last modified: 06 Jun 2018 12:21

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