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Maternal inflammation at delivery affects assessment of maternal iron status.
J Nutr. 2014 Oct; 144(10):1524-32.JN

Abstract

Pregnant adolescents (aged ≤ 18 y, n = 253) were followed from ≥ 12 wk of gestation to delivery to assess longitudinal changes in anemia and iron status and to explore associations between iron status indicators, hepcidin, and inflammatory markers. Hemoglobin, soluble transferrin receptor (sTfR), ferritin, serum iron, erythropoietin (EPO), hepcidin, C-reactive protein, interleukin-6 (IL-6), folate, and vitamin B-12 were measured, and total body iron (TBI) (milligrams per kilogram) was calculated using sTfR and ferritin values. Anemia prevalence increased from trimesters 1 and 2 (3-5%, <28 wk) to trimester 3 (25%, 33.2 ± 3.7 wk, P < 0.0001). The prevalence of iron deficiency (sTfR > 8.5 mg/L) doubled from pregnancy to delivery (7% to 14%, P = 0.04). Ferritin and hepcidin concentrations at delivery may have been elevated as a consequence of inflammation because IL-6 concentrations at delivery were 1.6-fold higher than those obtained at 26.1 ± 3.3 wk of gestation (P < 0.0001), and a positive association was found between IL-6 and both hepcidin and ferritin at delivery (P < 0.01). EPO was consistently correlated with hemoglobin (r = -0.36 and -0.43, P < 0.001), ferritin (r = -0.37 and -0.32, P < 0.0001), sTfR (r = 0.35 and 0.25, P < 0.001), TBI (r = -0.44 and -0.37, P < 0.0001), and serum iron (r = -0.22 and -0.16, P < 0.05) at mid-gestation and at delivery, respectively. EPO alone explained the largest proportion of variance in hemoglobin at 26.0 ± 3.3 wk of gestation (R(2) = 0.13, P = 0.0001, n = 113) and at delivery (R(2) = 0.19, P < 0.0001, n = 192). Pregnant adolescents are at high risk of anemia. EPO is a sensitive indicator of iron status across gestation, is not affected by systemic inflammation, and may better predict risk of anemia at term. The trial was registered at clinicaltrials.gov as NCT01019902.

Authors+Show Affiliations

Division of Nutritional Sciences, Cornell University, Ithaca, NY.University of Rochester School of Medicine and Dentistry, Rochester, NY; and.University of Rochester School of Medicine and Dentistry, Rochester, NY; and.Intrinsic Life Sciences, La Jolla, CA.University of Rochester School of Medicine and Dentistry, Rochester, NY; and.University of Rochester School of Medicine and Dentistry, Rochester, NY; and.Division of Nutritional Sciences, Cornell University, Ithaca, NY koo4@cornell.edu.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25080540

Citation

Lee, Sunmin, et al. "Maternal Inflammation at Delivery Affects Assessment of Maternal Iron Status." The Journal of Nutrition, vol. 144, no. 10, 2014, pp. 1524-32.
Lee S, Guillet R, Cooper EM, et al. Maternal inflammation at delivery affects assessment of maternal iron status. J Nutr. 2014;144(10):1524-32.
Lee, S., Guillet, R., Cooper, E. M., Westerman, M., Orlando, M., Pressman, E., & O'Brien, K. O. (2014). Maternal inflammation at delivery affects assessment of maternal iron status. The Journal of Nutrition, 144(10), 1524-32. https://doi.org/10.3945/jn.114.191445
Lee S, et al. Maternal Inflammation at Delivery Affects Assessment of Maternal Iron Status. J Nutr. 2014;144(10):1524-32. PubMed PMID: 25080540.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal inflammation at delivery affects assessment of maternal iron status. AU - Lee,Sunmin, AU - Guillet,Ronnie, AU - Cooper,Elizabeth M, AU - Westerman,Mark, AU - Orlando,Mark, AU - Pressman,Eva, AU - O'Brien,Kimberly O, Y1 - 2014/07/30/ PY - 2014/8/1/entrez PY - 2014/8/1/pubmed PY - 2015/1/21/medline SP - 1524 EP - 32 JF - The Journal of nutrition JO - J Nutr VL - 144 IS - 10 N2 - Pregnant adolescents (aged ≤ 18 y, n = 253) were followed from ≥ 12 wk of gestation to delivery to assess longitudinal changes in anemia and iron status and to explore associations between iron status indicators, hepcidin, and inflammatory markers. Hemoglobin, soluble transferrin receptor (sTfR), ferritin, serum iron, erythropoietin (EPO), hepcidin, C-reactive protein, interleukin-6 (IL-6), folate, and vitamin B-12 were measured, and total body iron (TBI) (milligrams per kilogram) was calculated using sTfR and ferritin values. Anemia prevalence increased from trimesters 1 and 2 (3-5%, <28 wk) to trimester 3 (25%, 33.2 ± 3.7 wk, P < 0.0001). The prevalence of iron deficiency (sTfR > 8.5 mg/L) doubled from pregnancy to delivery (7% to 14%, P = 0.04). Ferritin and hepcidin concentrations at delivery may have been elevated as a consequence of inflammation because IL-6 concentrations at delivery were 1.6-fold higher than those obtained at 26.1 ± 3.3 wk of gestation (P < 0.0001), and a positive association was found between IL-6 and both hepcidin and ferritin at delivery (P < 0.01). EPO was consistently correlated with hemoglobin (r = -0.36 and -0.43, P < 0.001), ferritin (r = -0.37 and -0.32, P < 0.0001), sTfR (r = 0.35 and 0.25, P < 0.001), TBI (r = -0.44 and -0.37, P < 0.0001), and serum iron (r = -0.22 and -0.16, P < 0.05) at mid-gestation and at delivery, respectively. EPO alone explained the largest proportion of variance in hemoglobin at 26.0 ± 3.3 wk of gestation (R(2) = 0.13, P = 0.0001, n = 113) and at delivery (R(2) = 0.19, P < 0.0001, n = 192). Pregnant adolescents are at high risk of anemia. EPO is a sensitive indicator of iron status across gestation, is not affected by systemic inflammation, and may better predict risk of anemia at term. The trial was registered at clinicaltrials.gov as NCT01019902. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/25080540/Maternal_inflammation_at_delivery_affects_assessment_of_maternal_iron_status_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.114.191445 DB - PRIME DP - Unbound Medicine ER -