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Clinical Trial
. 2021 Aug 7;151(8):2296-2304.
doi: 10.1093/jn/nxab133.

Maternal Overweight and Obesity during Pregnancy Are Associated with Neonatal, but Not Maternal, Hepcidin Concentrations

Andrew D Jones  1 , Zhen Shi  2   3 , Nathalie J Lambrecht  1 , Yaping Jiang  2 , Jingmin Wang  2 , Margit Burmeister  4   5   6 , Ming Li  2 , Betsy Lozoff  7
Affiliations
Clinical Trial

Maternal Overweight and Obesity during Pregnancy Are Associated with Neonatal, but Not Maternal, Hepcidin Concentrations

Andrew D Jones et al. J Nutr. .

Abstract

Background: Overweight or obesity among pregnant women may compromise maternal and neonatal iron status by upregulating hepcidin.

Objectives: This study determined the association of 1) maternal and neonatal iron status with maternal and neonatal hepcidin concentrations, and 2) maternal prepregnancy weight status with maternal and neonatal hepcidin concentrations.

Methods: We examined hematologic data from 405 pregnant women and their infants from the placebo treatment group of a pregnancy iron supplementation trial in rural China. We measured hepcidin, serum ferritin (SF), soluble transferrin receptor (sTfR), and high-sensitivity C-reactive protein in maternal blood samples at mid-pregnancy and in cord blood at delivery. We used regression analysis to examine the association of maternal prepregnancy overweight or obese status with maternal hepcidin concentration in mid-pregnancy and cord hepcidin concentrations. We also used path analysis to examine mediation of the association of maternal prepregnancy overweight or obese status with maternal iron status by maternal hepcidin, as well as with neonatal hepcidin by neonatal iron status.

Results: Maternal iron status was positively correlated with maternal hepcidin at mid-pregnancy (SF: r = 0.63, P < 0.001; sTfR: r = -0.37, P < 0.001). Neonatal iron status was also positively correlated with cord hepcidin (SF: r = 0.61, P < 0.001; sTfR: r = -0.39, P < 0.001). In multiple linear regression models, maternal prepregnancy overweight or obese status was not associated with maternal hepcidin at mid-pregnancy but was associated with lower cord hepcidin (coefficient = -0.21, P = 0.004). Using path analysis, we observed a significant indirect effect of maternal prepregnancy overweight or obese status on cord hepcidin, mediated by neonatal iron status.

Conclusions: In both pregnant women and neonates, hepcidin was responsive to iron status. Maternal prepregnancy overweight status, with or without including obese women, was associated with lower cord blood hepcidin, likely driven by lower iron status among the neonates of these mothers.

Keywords: China; hepcidin; iron deficiency; obesity; pregnancy.

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Figures

FIGURE 1
FIGURE 1
Association of maternal and cord blood iron status with maternal and cord blood hepcidin concentrations, respectively. (A) Associations of maternal SF and sTfR with maternal hepcidin concentrations in mid-pregnancy. (B) Associations of cord ferritin and sTfR with cord hepcidin concentrations. n = 405 for all associations. P values are shown for Pearson product-moment rs. SF, serum ferritin; sTfR, soluble transferrin receptor.
FIGURE 2
FIGURE 2
Path diagram with path coefficients showing the associations of maternal prepregnancy overweight or obese status with neonatal (cord) hepcidin mediated by neonatal (cord SF) iron status. *,**,***Statistically significant standardized path coefficient: *P < 0.1, **P < 0.05, ***P < 0.01. SF, serum ferritin.
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Comment in

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