Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
The University of Rochester School of Medicine, Rochester, NY, USA.
Pediatr Res. 2018 Aug;84(2):199-204. doi: 10.1038/s41390-018-0044-6. Epub 2018 Jun 15.
Iron (Fe) status of neonates born to women carrying multiple fetuses might be compromised as a consequence of the high prevalence of maternal Fe deficiency and anemia coupled with an increased risk of preterm birth. This study aimed to characterize and identify determinants of anemia in this neonatal population.
Umbilical cord blood obtained from 183 neonates was utilized to assess hemoglobin (Hb), ferritin (SF), soluble transferrin receptor (sTfR), hepcidin, serum Fe, erythropoietin, folate, vitamin B-12, C-reactive protein, and interleukin-6. Associations with maternal Fe status were explored.
Cord Hb or SF did not change significantly as a function of gestational age at birth (25-38 wks). Neonates born to women who were obese prior to pregnancy or smoked cigarettes during pregnancy had a 4-5-fold greater odds of anemia at birth. Cord sTfR was the strongest indicator of cord Hb (P < 0.0001), and it was significantly associated with maternal sTfR at mid-gestation (P = 0.01) and delivery (P = 0.002). Cord Fe indicators were significantly associated with cord hepcidin, but not maternal hepcidin.
Screening for Fe status in neonates born to women carrying multiple fetuses is warranted, especially for those born to smokers or to women who are obese at entry into pregnancy.
携带多胎的孕妇铁（Fe）状态通常因铁缺乏和贫血的高患病率以及早产风险增加而受损。本研究旨在描述和确定该新生儿人群贫血的决定因素。
利用 183 名新生儿的脐血评估血红蛋白（Hb）、铁蛋白（SF）、可溶性转铁蛋白受体（sTfR）、hepcidin、血清铁、促红细胞生成素、叶酸、维生素 B-12、C 反应蛋白和白细胞介素 6。探讨与母体铁状态的关联。
脐带血 Hb 或 SF 随出生时的胎龄（25-38 周）无明显变化。与怀孕前肥胖或怀孕期间吸烟的孕妇所生的新生儿相比，出生时贫血的几率高 4-5 倍。脐带 sTfR 是脐带 Hb 的最强指标（P<0.0001），与妊娠中期（P=0.01）和分娩时（P=0.002）母体 sTfR 显著相关。脐带铁指标与脐带 hepcidin 显著相关，但与母体 hepcidin 无关。
对于携带多胎的孕妇所生的新生儿，尤其是对于吸烟的孕妇或怀孕前肥胖的孕妇，有必要筛查 Fe 状态。
