Brief reportSub-Optimal Fetal Iron Acquisition under a Maternal Environment
Introduction
Increasing evidence demonstrates that fetal iron acquisition through gestation is limited in the presence of maternal iron deficiency (ID) (1). Cord serum ferritin (cord SF) decreases after maternal serum ferritin (MSF) has fallen below 12 μg/L (2). Although iron stores (IS) at birth show considerable variation, they correlate with IS throughout the first year of life (3). Storage iron decreases progressively after birth 3, 4 due to the need to maintain a near constant mean hemoglobin (Hb) concentration of 125 g/L within a rapidly expanding blood volume, particularly between the ages of 4 and 12 months (5), when infants depend on the iron acquired from the mother before birth. Such a demand leaves the infant susceptible to ID. In these circumstances, less well-iron-endowed babies will be at a higher risk for the development of full ID later in infancy (3).
The present investigation was undertaken to determine the effect of maternal ID on the IS of neonates born to a group of low-income women with a high likelihood to be iron deficient, in order to evaluate the need for an interventional trial on the study population. Maternal findings have been reported elsewhere (6), and data pertinent to this study have been incorporated when necessary to provide the adequate context for the findings in their neonates.
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Patients and Methods
The study was conducted at the “José E. Gonzalez” University Hospital in the city of Monterrey, Mexico (534 m above sea level). After obtaining maternal informed consent, cord hemoglobin (cord Hb) and cord SF concentrations were measured in cord blood drawn at birth in 201 consecutive healthy full-term neonates. Delayed cord clamping at delivery was not routinely practiced. All of the newborns were the product of a single, uncomplicated pregnancy. The mothers' last menstruation date, echography
Results
The mean cord SF concentration in the group of 201 neonates was 81.0 ± 63 μg/L; mean MSF was 7.0 ± 6.4 μg/L. For purposes of this study, newborns were classified into three groups depending on their cord SF concentration (Table 1). Neonatal ID (group I), defined by a cord SF value <12.0 μg/L, was documented in 13 neonates (6.5%), whose cord SF concentration was 7.1 ± 3.5 μg/L.
The group of neonates born with reduced iron reserves (group II) included 15 babies (7.5%) with a mean cord SF value of
Discussion
Our results suggest that neonatal iron stores in the study group were influenced by maternal storage iron levels. This was reflected in a difference of 30 μg/L on mean cord SF in favor of neonates born to women with a MSF ≥12.0 μg/L and 21.0 μg/L in favor of babies born to mothers who consistently ingested iron supplements, underscoring the importance of improving maternal iron supplementation programs as a first line intervention to increase newborn stores of iron, following established
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