STUDY OF ASSOCIATION BETWEEN SERUM FERRITIN LEVELS AT TERM PREGNANCY IN WOMEN WITH IRON DEFICIENCY ANAEMIA (IDA) AND NEW BORN SERUM FERRITIN LEVELS

Main Article Content

Dr. Smruti Ranjan Jena
Dr. Saumya Nanda
Dr. Bibhu Prasad Nayak
Dr Bipsa Singh
Dr. Puspanjali Khuntia

Keywords

Serum Ferritin Levels, Pregnancy, IDA, New-Born Serum Ferritin Levels.

Abstract

Background: In order to determine whether there is an association between the two, we compared the haemoglobin and serum ferritin levels of newborns delivered vaginally or by caesarean section to those of non-anaemic mothers and their newborns with iron deficiency anaemia.


Methods: The study involved recruiting 150 full-term mothers who were admitted through the OPD or labour room of Department of Obstetrics and Gynaecology, with age ranging from 18 to 40 years, who were in labour and had full-term new-borns without any prenatal or perinatal complications. The study was conducted at the Department of Obstetrics and Gynaecology, in a Tertiary care hospital of eastern India.


Results: During their pregnancy, 61% of patients did not take IFA (Iron Folic acid), compared to 28% of controls. The results of the analysis and computation of the p-value indicated that the data was statistically significant. The analysis revealed a strong link between the haemoglobin & serum ferritin levels of mothers and newborns. We applied the Spearman-Rho correlation test because the data was not normally distributed, and the results were significant. Because neonates delivered from Iron deficiency anaemia (IDA) women had considerably lower haemoglobin and ferritin concentrations than newborns delivered from non-anaemic (NA) mothers, maternal IDA has an impact on the iron reserve of newborns. To established relationship between the haemoglobin status of mothers and newborns in cases and controls, an independent t-test was used to


analyse the data, and statistical significance was observed.


Conclusion: Maternal IDA may have an impact on newborns' iron reserve. For foetal development to occur in utero and for storage of sufficient iron at birth to support growth in the early stages of infancy, there must be an ideal transfer of iron across the placenta. It appears that foetal iron requirements could be partially satisfied but not completely satisfied if maternal iron resources were exhausted. More research is needed to determine the association of the degree of lower cord serum Ferritin (SF) with the iron status and the developmental outcome of later part of infancy.

Abstract 62 | PDF Downloads 52

References

[1] International Institute for Population Sciences (IIPS) and ICF. 2021. National Family Health Survey (NFHS-5), 2019-21: India: Volume II. Mumbai: IIPS..
[2] WHO (2001) Iron deficiency anemia: assessment, prevention and control. WHO/NHD/01.3, Geneva. World Health Organization, Switzerland
[3] Geng F, Mai X, Zhan J, Xu L, Georgieff M, Shao J, Lozoff B. Timing of iron deficiency and recognition memory in infancy. Nutritional Neuroscience, 2020; January 7:1–10
[4] Armony-Sivan R, Eidelman AI, Lanir A, Sredni D, Yehuda S. Iron status and neurobehavioral development of premature infants. J Perinatol. 2004; 24:757–762.
[5] Sangkhae, V., Fisher, A. L., Ganz, T., & Nemeth, E. (2023). Iron Homeostasis During Pregnancy: Maternal, Placental, and Fetal Regulatory Mechanisms. https://doi.org/10.1146/annurev-nutr-061021-030404
[6] Kumar A, Rai AK, Basu S, Dash D, Singh JS. Cord blood and breast milk iron status in maternal anemia. Pediatrics. 2008 Mar;121(3): e673-7.
doi:10.1542/peds.2007-1986. PMID: 18310187.
[7] El-Farrash RA, Ismail EA, Nada AS. Cord blood iron profile and breast milk micronutrients in maternal iron deficiency anemia. Pediatr Blood Cancer. 2012 Feb;58(2):233-8. doi: 10.1002/pbc.23184. Epub 2011 May 5. PMID: 21548016.
[8] Singla PN, Tyagi M, Shankar R, Dash D, Kumar A. Fetal iron status in maternal anemia. Acta Paediatr. 1996 Nov;85(11):1327-30. doi: 10.1111/j.1651-2227. 1996. tb13919.x. PMID: 8955460.
[9] Sweet DG, Savage G, Tubman TR, Lappin TR, Halliday HL. Study of maternal influences on fetal iron status at term using cord blood transferrin receptors. Arch Dis Child Fetal Neonatal Ed. 2001 Jan;84(1):F40-3. doi: 10.1136/fn.84.1.f40. PMID: 11124923; PMCID: PMC1721190.
[10] Hussain MA, Gaafar TH, Laulicht M, Hoffebrand AV. Relation of maternal and cord blood serum ferritin. Arch Dis Child. 1977 Oct;52(10):782-4. doi: 10.1136/adc.52.10.782. PMID: 931424; PMCID: PMC1544792.
[11] Akhter S, Momen MA, Rahman MM, Parveen T, Karim RK. Effect of maternal anemia on fetal outcome. Mymensingh Med J. 2010 Jul;19(3):391-8. PMID: 20639833.
[12] Wong CT, Saha N. Inter-relationships of storage iron in the mother, the placenta and the newborn. Acta Obstet Gynecol Scand. 1990;69(7-8):613-6. doi: 10.3109/00016349009028705. PMID: 2094143.
[13] Reihaneh Hadipour, A.K. Norimah, B.K. Poh, F. Firoozehchian, Raheleh Hadipour and A. Akaberi, 2010. Haemoglobin and Serum Ferritin Levels in Newborn Babies Born to Anaemic Iranian Women: a Cross-Sectional Study in an Iranian Hospital. Pakistan JournalofNutrition,9:562-566. DOI: 10.3923/pjn.2010.562.566
[14] Paiva Ade A, Rondó PH, Pagliusi RA, Latorre Mdo R, Cardoso MA, Gondim SS. Relationship between the iron status of pregnant women and their newborns. Rev Saude Publica. 2007 Jun;41(3):321-7. doi: 10.1590/s0034-89102007000300001. PMID: 17515983.
[15] Walters GO, Miller FM, Worwood M. Serum ferritin concentration and iron stores in normal subjects. J Clin Pathol. 1973 Oct;26(10):770-2. doi: 10.1136/jcp.26.10.770. PMID: 4750458; PMCID: PMC477879.
[16] Hay G, Refsum H, Whitelaw A, Melbye EL, Haug E, Borch-Iohnsen B. Predictors of serum ferritin and serum soluble transferrin receptor in newborns and their associations with iron status during the first 2 y of life. Am J Clin Nutr. 2007 Jul;86(1):64-73. doi: 10.1093/ajcn/86.1.64. PMID: 17616764.
[17] MacPhail AP, Charlton RW, Bothwell TH, Torrance JD. The relationship between maternal and infant iron status. Scand J Haematol. 1980 Aug;25(2):141-50. doi: 10.1111/j.1600-0609.1981.tb01379.x. PMID: 7466303.
[18] Kilbride J, Baker TG, Parapia LA, Khoury SA, Shuqaidef SW, Jerwood D. Anaemia during pregnancy as a risk factor for iron-deficiency anaemia in infancy: a case-control study in Jordan. Int J Epidemiol. 1999 Jun;28(3):461-8. doi: 10.1093/ije/28.3.461. PMID: 10405849.
[19] Strauss MB. ANEMIA OF INFANCY FROM MATERNAL IRON DEFICIENCY IN PREGNANCY. J Clin Invest. 1933 Mar;12(2):345-53. doi: 10.1172/JCI100507. PMID: 16694132; PMCID: PMC435912.
[20] Hokama T, Takenaka S, Hirayama K, Yara A, Yoshida K, Itokazu K, Kinjho R, Yabu E. Iron status of newborns born to iron deficient anaemic mothers. J Trop Pediatr. 1996 Apr;42(2):75-7. doi: 10.1093/tropej/42.2.75. PMID: 8984218.
[21] Emamghorashi F, Heidari T. Iron status of babies born to iron-deficient anaemic mothers in an Iranian hospital. East Mediterr Health J 2004;10:808-14.
[22] Gupta R, Ramji S. Effect of delayed cord clamping on iron stores in infants born to anemic mothers: a randomized controlled trial. Indian Pediatr. 2002 Feb;39(2):130-5. PMID: 11867842.
[23] Türkay S, Tanzer F, Gültekin A, Bakici MZ. The influence of maternal iron deficiency anaemia on the haemoglobin concentration of the infant. J Trop Pediatr. 1995 Dec;41(6):369-71. doi: 10.1093/tropej/41.6.369. PMID: 8606448.
[24] Gambling L, Lang C, McArdle HJ. Fetal regulation of iron transport during pregnancy. Am J Clin Nutr. 2011 Dec;94(6 Suppl):1903S-1907S. doi: 10.3945/ajcn.110.000885. Epub 2011 May 4. PMID: 21543532.
[25] Petry CD, Wobken JD, McKay H, Eaton MA, Seybold VS, Johnson DE, Georgieff MK. Placental transferrin receptor in diabetic pregnancies with increased fetal iron demand. Am J Physiol. 1994 Oct;267(4 Pt 1):E507-14. doi: 10.1152/ajpendo.1994.267.4.E507. PMID: 7943298.
[26] Young MF, Pressman E, Foehr ML, McNanley T, Cooper E, Guillet R, Orlando M, McIntyre AW, Lafond J, O'Brien KO. Impact of maternal and neonatal iron status on placental transferrin receptor expression in pregnant adolescents. Placenta. 2010 Nov;31(11):1010-4. doi: 10.1016/j.placenta.2010.08.009. Epub 2010 Sep 15. PMID: 20828813.
[27] Liao QK, Kong PA, Gao J, Li FY, Qian ZM. Expression of ferritin receptor in placental microvilli membrane in pregnant women with different iron status at mid-term gestation. Eur J Clin Nutr. 2001 Aug;55(8):651-6. doi: 10.1038/sj.ejcn.1601195. PMID: 11477463.
[28] O'Brien KO, Zavaleta N, Abrams SA, Caulfield LE. Maternal iron status influences iron transfer to the fetus during the third trimester of pregnancy. Am J Clin Nutr. 2003 Apr;77(4):924-30. doi: 10.1093/ajcn/77.4.924. PMID: 12663293.
[29] Lubach GR, Coe CL. Preconception maternal iron status is a risk factor for iron deficiency in infant rhesus monkeys (Macaca mulatta). J Nutr. 2006 Sep;136(9):2345-9. doi: 10.1093/jn/136.9.2345. PMID: 16920852.
[30] Fullerton HW. The iron-deficiency anaemia of late infancy. Arch Dis Child. 1937 Apr;12(68):91-110. doi: 10.1136/adc.12.68.91. PMID: 21032063; PMCID: PMC1975505.
[31] Allen LH. Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr. 2000 May;71(5 Suppl):1280S-4S. doi: 10.1093/ajcn/71.5.1280s. PMID: 10799402.
[32] Ronnenberg AG, Wood RJ, Wang X, Xing H, Chen C, Chen D, Guang W, Huang A, Wang L, Xu X. Preconception hemoglobin and ferritin concentrations are associated with pregnancy outcome in a prospective cohort of Chinese women. J Nutr. 2004 Oct;134(10):2586-91. doi: 10.1093/jn/134.10.2586. PMID: 15465752.