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Iron deficiency in early pregnancy using serum ferritin and soluble transferrin receptor concentrations are associated with pregnancy and birth outcomes.
Eur J Clin Nutr. 2016 Mar; 70(3):358-63.EJ

Abstract

BACKGROUND/OBJECTIVES

There are several biomarkers for measuring iron deficiency (ID) in pregnancy, but the prevalence of ID and its association with inflammation and adverse pregnancy outcomes is inconclusive. The aim of this work was to describe the prevalence and determinants of first trimester ID and associations with pregnancy and birth outcomes.

SUBJECTS/METHODS

A record-linkage cohort study of archived serum samples of women attending first trimester screening and birth and hospital data to ascertain maternal characteristics and pregnancy outcomes. Sera were analysed for iron stores (ferritin; μg/l), lack of iron in the tissues (soluble transferrin receptor (sTfR); nmol/l) and inflammatory (C-reactive protein (CRP); mg/dl) biomarkers. Total body iron (TBI) was calculated from serum ferritin (SF) and sTfR concentrations. Multivariate logistic regression analysed risk factors and pregnancy outcomes associated with ID using the definitions: SF<12 μg/l, TfR ⩾ 21.0 nmol/l, and TBI<0 mg/kg.

RESULTS

Of the 4420 women, the prevalence of ID based on ferritin, sTfR and TBI was 19.6, 15.3 and 15.7%, respectively. Risk factors of ID varied depending on which iron parameter was used and included maternal age <25 years, multiparity, socioeconomic disadvantage, high maternal body weight and inflammation. ID, defined by SF and TBI but not TfR, was associated with reduced risk of gestational diabetes mellitus (GDM). ID defined using TBI only was associated with increased risk of large-for-gestation-age (LGA) infants.

CONCLUSIONS

Nearly one in five Australian women begin pregnancy with ID. Further investigation of excess maternal weight and inflammation in the relationships between ID and GDM and LGA infants is needed.

Authors+Show Affiliations

Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia.Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.Division of Perinatal Research, Kolling Institute, University of Sydney, Royal North Shore Hospital, St Leonards, NSW, Australia.Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.

Pub Type(s)

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

Language

eng

PubMed ID

26373962

Citation

Khambalia, A Z., et al. "Iron Deficiency in Early Pregnancy Using Serum Ferritin and Soluble Transferrin Receptor Concentrations Are Associated With Pregnancy and Birth Outcomes." European Journal of Clinical Nutrition, vol. 70, no. 3, 2016, pp. 358-63.
Khambalia AZ, Collins CE, Roberts CL, et al. Iron deficiency in early pregnancy using serum ferritin and soluble transferrin receptor concentrations are associated with pregnancy and birth outcomes. Eur J Clin Nutr. 2016;70(3):358-63.
Khambalia, A. Z., Collins, C. E., Roberts, C. L., Morris, J. M., Powell, K. L., Tasevski, V., & Nassar, N. (2016). Iron deficiency in early pregnancy using serum ferritin and soluble transferrin receptor concentrations are associated with pregnancy and birth outcomes. European Journal of Clinical Nutrition, 70(3), 358-63. https://doi.org/10.1038/ejcn.2015.157
Khambalia AZ, et al. Iron Deficiency in Early Pregnancy Using Serum Ferritin and Soluble Transferrin Receptor Concentrations Are Associated With Pregnancy and Birth Outcomes. Eur J Clin Nutr. 2016;70(3):358-63. PubMed PMID: 26373962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Iron deficiency in early pregnancy using serum ferritin and soluble transferrin receptor concentrations are associated with pregnancy and birth outcomes. AU - Khambalia,A Z, AU - Collins,C E, AU - Roberts,C L, AU - Morris,J M, AU - Powell,K L, AU - Tasevski,V, AU - Nassar,N, Y1 - 2015/09/16/ PY - 2015/03/05/received PY - 2015/07/29/revised PY - 2015/07/31/accepted PY - 2015/9/17/entrez PY - 2015/9/17/pubmed PY - 2016/12/23/medline SP - 358 EP - 63 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 70 IS - 3 N2 - BACKGROUND/OBJECTIVES: There are several biomarkers for measuring iron deficiency (ID) in pregnancy, but the prevalence of ID and its association with inflammation and adverse pregnancy outcomes is inconclusive. The aim of this work was to describe the prevalence and determinants of first trimester ID and associations with pregnancy and birth outcomes. SUBJECTS/METHODS: A record-linkage cohort study of archived serum samples of women attending first trimester screening and birth and hospital data to ascertain maternal characteristics and pregnancy outcomes. Sera were analysed for iron stores (ferritin; μg/l), lack of iron in the tissues (soluble transferrin receptor (sTfR); nmol/l) and inflammatory (C-reactive protein (CRP); mg/dl) biomarkers. Total body iron (TBI) was calculated from serum ferritin (SF) and sTfR concentrations. Multivariate logistic regression analysed risk factors and pregnancy outcomes associated with ID using the definitions: SF<12 μg/l, TfR ⩾ 21.0 nmol/l, and TBI<0 mg/kg. RESULTS: Of the 4420 women, the prevalence of ID based on ferritin, sTfR and TBI was 19.6, 15.3 and 15.7%, respectively. Risk factors of ID varied depending on which iron parameter was used and included maternal age <25 years, multiparity, socioeconomic disadvantage, high maternal body weight and inflammation. ID, defined by SF and TBI but not TfR, was associated with reduced risk of gestational diabetes mellitus (GDM). ID defined using TBI only was associated with increased risk of large-for-gestation-age (LGA) infants. CONCLUSIONS: Nearly one in five Australian women begin pregnancy with ID. Further investigation of excess maternal weight and inflammation in the relationships between ID and GDM and LGA infants is needed. SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/26373962/Iron_deficiency_in_early_pregnancy_using_serum_ferritin_and_soluble_transferrin_receptor_concentrations_are_associated_with_pregnancy_and_birth_outcomes_ L2 - https://doi.org/10.1038/ejcn.2015.157 DB - PRIME DP - Unbound Medicine ER -