Cao Chang, Pressman Eva K, Cooper Elizabeth M, Guillet Ronnie, Westerman Mark, O'Brien Kimberly O
Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA.
Reprod Sci. 2016 May;23(5):613-22. doi: 10.1177/1933719115607976. Epub 2015 Sep 29.
To assess the impact of maternal obesity and excessive gestational weight gain (GWG) on maternal and neonatal iron status and to explore the possible mediating role of inflammation on hepcidin.
This analysis included 230 pregnant adolescents (13-18 years) enrolled in either a longitudinal or a cross-sectional study. Prepregnancy body mass index (ppBMI) and GWG were obtained from medical records. Maternal iron status (hemoglobin, serum iron, ferritin, transferrin receptor, total body iron, and hepcidin) and inflammation (interleukin-6 [IL-6] and leptin) were assessed at midgestation (26.2 ± 3.3 weeks) in the longitudinal cohort and at delivery (39.8 ± 1.3 weeks) in both study cohorts. Cord blood was collected in both studies and analyzed for iron indicators.
Approximately 40% of the adolescents entered pregnancy overweight or obese. Multivariate analysis identified ppBMI as a negative predictor of serum iron at midgestation (P = .009) and a positive predictor of serum hepcidin at delivery (P = .02). None of the other maternal iron status indicators were significantly associated with ppBMI or GWG. Serum IL-6 was significantly positively associated with hepcidin at delivery (P = .0001) but not at midgestation. There was a positive relationship between ppBMI and cord hemoglobin (P = .03).
These results suggest that adiposity-related inflammation does not override the iron-mediated signals that regulate hepcidin production during pregnancy, and in this adolescent cohort, there is no strong evidence for a detrimental effect of maternal obesity and excessive weight gain on iron status in the offspring at birth.
评估孕妇肥胖及孕期体重过度增加（GWG）对母体和新生儿铁状态的影响，并探讨炎症在铁调素上可能的中介作用。
本分析纳入了230名怀孕的青少年（13 - 18岁），他们参与了一项纵向研究或横断面研究。孕前体重指数（ppBMI）和GWG通过病历获得。在纵向队列中，于孕中期（26.2 ± 3.3周）评估母体铁状态（血红蛋白、血清铁、铁蛋白、转铁蛋白受体、全身铁和铁调素）及炎症（白细胞介素-6 [IL-6]和瘦素）；在两项研究队列中，于分娩时（39.8 ± 1.3周）进行评估。两项研究均采集脐带血并分析铁指标。
约40%的青少年怀孕时超重或肥胖。多变量分析确定ppBMI是孕中期血清铁的负向预测因子（P = .009），是分娩时血清铁调素的正向预测因子（P = .02）。其他母体铁状态指标均与ppBMI或GWG无显著关联。分娩时血清IL-6与铁调素显著正相关（P = .0001），但孕中期无此关联。ppBMI与脐带血红蛋白呈正相关（P = .03）。
这些结果表明，肥胖相关炎症并未超越调节孕期铁调素产生的铁介导信号，并且在这个青少年队列中，没有有力证据表明孕妇肥胖和体重过度增加对出生时后代的铁状态有不利影响。
