McCarthy E K, Kenny L C, Hourihane J O B, Irvine A D, Murray D M, Kiely M E
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland.
The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Republic of Ireland.
Eur J Clin Nutr. 2017 Jun;71(6):782-787. doi: 10.1038/ejcn.2016.255. Epub 2016 Dec 21.
BACKGROUND/OBJECTIVES: Low serum ferritin concentrations at birth, which reflect neonatal iron stores, track through to early childhood and have been associated with poorer neurodevelopmental outcomes. We aimed to identify maternal, antenatal and birth-associated factors that influence iron stores at birth in a prospective maternal-infant birth cohort.
SUBJECTS/METHODS: In a population-based, longitudinal, birth cohort in Ireland, 413 maternal-infant dyads with prospectively collected lifestyle and clinical data from 15 weeks' gestation had umbilical cord serum ferritin concentrations measured. Regression models were developed to identify independent factors associated with cord ferritin concentrations.
Median (IQR) cord ferritin concentrations were 185.7 (131.7, 385.5) μg/l, and 8% (n=33) of infants had low iron stores (ferritin <76 μg/l) at birth. Maternal obesity (BMI ⩾30 kg/m) at 15 weeks' gestation (adj. estimate (95% confidence interval (CI)): -66.4 (-106.9, -25.9) μg/l, P<0.0001) and delivery by caesarean section (-38.8 (-70.2, -7.4) μg/l, P=0.016) were inversely associated with cord ferritin concentrations. In addition, maternal smoking at 15 weeks' gestation (adj. odds ratio (95% CI): 2.9 (1.2, 7), P=0.020) and being born small-for-gestational age (3.4 (1.3, 8.9), P=0.012) were associated with an increased risk of low iron stores (ferritin <76 μg/l) at birth.
We have identified a number of potentially modifiable lifestyle factors that influence iron stores at birth, with the important role of overall maternal health and lifestyle during pregnancy highlighted. Public health policies targeting women of child-bearing age to improve nutrition and health outcomes should be prioritised for the health of the next generation.
背景/目的：出生时血清铁蛋白浓度低反映了新生儿的铁储备情况，这种情况会持续到幼儿期，并与较差的神经发育结果相关。我们旨在确定在一个前瞻性母婴出生队列中，影响出生时铁储备的母亲、产前和与出生相关的因素。
对象/方法：在爱尔兰一个基于人群的纵向出生队列中，对413对母婴进行了研究，这些母婴从妊娠15周开始前瞻性收集了生活方式和临床数据，并测量了脐带血清铁蛋白浓度。建立回归模型以确定与脐带铁蛋白浓度相关的独立因素。
脐带铁蛋白浓度的中位数（四分位间距）为185.7（131.7，385.5）μg/l，8%（n = 33）的婴儿出生时铁储备低（铁蛋白<76μg/l）。妊娠15周时母亲肥胖（BMI⩾30kg/m²）（调整估计值（95%置信区间）：-66.4（-106.9，-25.9）μg/l，P<0.0001）和剖宫产分娩（-38.8（-70.2，-7.4）μg/l，P = 0.016）与脐带铁蛋白浓度呈负相关。此外，妊娠15周时母亲吸烟（调整比值比（95%置信区间）：2.9（1.2，7），P = 0.020）和小于胎龄儿出生（3.4（1.3，8.9），P = 0.012）与出生时铁储备低（铁蛋白<76μg/l）的风险增加相关。
我们确定了一些可能可改变的生活方式因素，这些因素会影响出生时的铁储备，突出了孕期母亲整体健康和生活方式的重要作用。为了下一代的健康，应优先制定针对育龄妇女的公共卫生政策，以改善营养和健康状况。
