Relationship between maternal iron and cord blood iron status: A prospective study
Background: Iron sufficiency is of paramount importance in the neonatal period. Controversy exists whether the transfer of iron to the fetus from the mother is determined by fetal demands or by maternal iron stores. Numerous studies correlating maternal and neonatal iron stores revealed conflicting results. Aims: To study the relationship between maternal and neonatal iron indices at birth and to observe the impact of gestational age on iron stores in neonates. Methods and Materials: This prospective study was conducted in neonatal care unit of the tertiary hospital. Total 195 mother and newborn pairs are enrolled in the study. Neonates were divided into groups based on gestational age. The maternal venous samples were collected 1 h ± 15 min before the delivery. Cord blood sample and venous samples were drawn from a peripheral vein in neonates who came for follow-up at 4 weeks. Samples were analyzed for hemoglobin (Hb), serum ferritin, serum iron, and total iron-binding capacity. Results: Significant positive correlation was found between maternal Hb and neonatal ferritin (Pearson’s correlation coefficient =0.26, p=0.002) and maternal iron and neonatal iron (Pearson’s correlation coefficient =0.294, p=0.000). Ferritin concentration of cord blood samples in neonates born to mothers with ferritin levels <12 μg/L showed significant correlation. Mean ferritin in preterm neonates (128.9±80.7 μg/dl) was significantly lower than in term neonates (156.9±78.6 μg/dl) (p=0.040). Mean Hb in preterm neonates (14.5±2.1 g/dl) was significantly lower than in term neonates (15.0±2.1 g/dl) (p=0.028). 4-week samples showed significantly lower serum iron concentrations in preterm when compared to term group. Serum ferritin levels at birth showed positive correlation at 4 weeks. (Pearson’s correlation coefficient =0.211, p=0.028). Conclusions: Neonatal iron stores are affected in case of severe maternal iron deficiency indicated by ferritin levels <12 μg/L. Gestational age has a significant impact on neonatal iron stores. Neonates with a deficient iron store at birth likely to have low iron stores at 4 weeks.