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Observational Study
. 2014 Jul;34(7):513-8.
doi: 10.1038/jp.2014.42. Epub 2014 Mar 20.

Neonatal iron status is impaired by maternal obesity and excessive weight gain during pregnancy

A K Phillips  1 , S C Roy  2 , R Lundberg  2 , T W Guilbert  1 , A P Auger  3 , S E Blohowiak  1 , C L Coe  4 , P J Kling  1
Affiliations
Observational Study

Neonatal iron status is impaired by maternal obesity and excessive weight gain during pregnancy

A K Phillips et al. J Perinatol. 2014 Jul.

Abstract

Objective: Maternal iron needs increase sixfold during pregnancy, but obesity interferes with iron absorption. We hypothesized that maternal obesity impairs fetal iron status.

Study design: Three hundred and sixteen newborns with risk factors for infantile iron deficiency anemia (IDA) were studied to examine obesity during pregnancy and neonatal iron status. Erythrocyte iron was assessed by cord blood hemoglobin (Hb), zinc protoporphyrin/heme (ZnPP/H) and reticulocyte-ZnPP/H, and storage iron by serum ferritin.

Result: Women with body mass index (BMI) ⩾ 30 kg m(-)(2), as compared with non-obese women, delivered larger offspring with higher reticulocyte-ZnPP/H and lower serum ferritin concentrations (P<0.05 for both). With increasing BMI, the estimated body iron was relatively lower (mg kg(-)(1)) and the ratio of total Hb-bound iron (mg) per total body iron (mg) increased. Maternal diabetes compromised infant iron status, but multivariate analysis demonstrated that obesity was an independent predictor.

Conclusion: Obesity during pregnancy and excessive weight gain are independent risk factors for iron deficiency in the newborn.

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Figures

Figure 1
Figure 1
Enrollees designated as obese or not obese either pre-pregnancy or at delivery.
Figure 2
Figure 2
Newborn size compared to BMI. Diabetes (closed circles, bold lines), non-diabetes (open circles, lighter regression lines). A. Birth weight all enrollees F1,314=20.0, R=0.25, p<0.0001; diabetes F1,79=17.2, R=0.42, p<0.0001; non-diabetes F1,229=8.9, R=0.19, p<0.003. B. Birth weight z score all enrollees F1,315=20.4, R=0.25, p<0.0001; diabetes, F1,78=14.6, R=0.40, p<0.0005; non-diabetes, F1,228=8.7, R=0.19, p<0.004.
Figure 3
Figure 3
Newborn iron indices compared to BMI. Diabetes (closed circles, bold line), non-diabetes (open circles, lighter regression line). A. ZnPP/H all F1,291= 6.3, R=0.14, p<0.02; diabetes F1,70=10.8, R=0.36, p<0.002; non-diabetes p=0.88. B. Plasma ferritin all F1,291=8.2, R=0.17, p<0.005; diabetes F1,72=12.2, R=0.39, p<0.0005; non-diabetes, p=0.35. C. Relative body stores of iron (mg/kg) all F1,287=6.6, R=0.16, p=0.01; diabetes F1,70=7.9, R=0.32, p<0.007; non-diabetes, p=0.20. D. Calculated total body Hb/body iron (mg/mg) all F1,273=10.3, R=0.19, p<0.002; diabetes F1,69=14.6, R=0.42, p<0.003; non-diabetes, p=0.10.
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