Maternal iron kinetics and maternal-fetal iron transfer in normal-weight and overweight pregnancy
1
Issued Date
2022-04-01
Resource Type
ISSN
00029165
eISSN
19383207
Scopus ID
2-s2.0-85128160567
Pubmed ID
34910118
Journal Title
American Journal of Clinical Nutrition
Volume
115
Issue
4
Start Page
1166
End Page
1179
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Clinical Nutrition Vol.115 No.4 (2022) , 1166-1179
Suggested Citation
Stoffel N.U., Zimmermann M.B., Cepeda-Lopez A.C., Cervantes-Gracia K., Llanas-Cornejo D., Zeder C., Tuntipopipat S., Moungmaithong S., Densupsoontorn N., Quack Loetscher K., Gowachirapant S., Herter-Aeberli I. Maternal iron kinetics and maternal-fetal iron transfer in normal-weight and overweight pregnancy. American Journal of Clinical Nutrition Vol.115 No.4 (2022) , 1166-1179. 1179. doi:10.1093/ajcn/nqab406 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85986
Title
Maternal iron kinetics and maternal-fetal iron transfer in normal-weight and overweight pregnancy
Other Contributor(s)
Abstract
Background: Inflammation during pregnancy may aggravate iron deficiency (ID) by increasing serum hepcidin and reducing iron absorption. This could restrict iron transfer to the fetus, increasing risk of infant ID and its adverse effects. Objectives: We aimed to assess whether iron bioavailability and/or iron transfer to the fetus is impaired in overweight/obese (OW) pregnant women with adiposity-related inflammation, compared with normal-weight (NW) pregnant women. Methods: In this prospective study, we followed NW (n = 43) and OW (n = 40) pregnant women who were receiving iron supplements from the 14th week of gestation to term and followed their infants to age 6 mo. We administered 57Fe and 58Fe in test meals mid-second and mid-third trimester, and measured tracer kinetics throughout pregnancy and infancy. Results: In total, 38 NW and 36 OW women completed the study to pregnancy week 36, whereas 30 NW and 27 OW mother-infant pairs completed the study to 6 mo postpartum. Both groups had comparable iron status, hemoglobin, and serum hepcidin throughout pregnancy. Compared with the NW, the OW pregnant women had 1) 43% lower fractional iron absorption (FIA) in the third trimester (P = 0.033) with median [IQR] FIA of 23.9% [11.4%-35.7%] and 13.5% [10.8%-19.5%], respectively; and 2) 17% lower maternal-fetal iron transfer from the first tracer (P = 0.051) with median [IQR] maternal-fetal iron transfer of 4.8% [4.2%-5.4%] and 4.0% [3.6%-4.6%], respectively. Compared with the infants born to NW women, infants born to OW women had lower body iron stores (BIS) with median [IQR] 7.7 [6.3-8.8] and 6.6 [4.6-9.2] mg/kg body weight at age 6 mo, respectively (P = 0.024). Prepregnancy BMI was a negative predictor of maternal-fetal iron transfer (β =-0.339, SE = 0.144, P = 0.025) and infant BIS (β =-0.237, SE = 0.026, P = 0.001). Conclusions: Compared with NW, OW pregnant women failed to upregulate iron absorption in late pregnancy, transferred less iron to their fetus, and their infants had lower BIS. These impairments were associated with inflammation independently of serum hepcidin. This trial was registered at clinicaltrials.gov as NCT02747316.