Department of Psychology, Harlow Center for Biological Psychology, Madison, WI.
School of Medicine and Public Health, Madison, WI; Department of Pediatrics, Division of Neonatology, University of Wisconsin-Madison, Madison, WI.
J Pediatr. 2018 Sep;200:166-173.e2. doi: 10.1016/j.jpeds.2018.04.040. Epub 2018 Jun 14.
To investigate the impact of maternal stress during pregnancy on newborn iron and stage 1 iron deficiency at 1 year of age.
In total, 245 mothers and their newborn infants (52% male; 72% white) were recruited at the Meriter Hospital Birthing Center on the basis of known risk factors for iron deficiency. Umbilical cord blood hemoglobin and zinc protoporphyrin/heme (ZnPP/H) were determined to evaluate erythrocyte iron and plasma ferritin was determined to reflect storage iron. Mothers retrospectively reported stress experienced previously during pregnancy on a 25-item questionnaire. Blood was also was collected from 79 infants who were breastfed at 1 year of age.
Maternal recall of distress and health concerns during pregnancy correlated with cord blood ZnPP/H indices (r = 0.21, P < .01), even in the absence of major traumatic events. When concurrent with other known risks for iron deficiency, including maternal adiposity, socioeconomic status, and race, maternal stress had a summative effect, lowering cord blood iron. At 1 year, 24% of infants who were breastfed had moderate iron deficiency (plasma ferritin <12 µg/L). Higher cord blood ZnPP/H was predictive of this moderate iron deficiency (95% CI 0.26-1.47, P = .007). When coincident with maternal reports of gestational stress, the likelihood of low plasma ferritin at 1 year increased 36-fold in breastfed infants as compared with low-stress pregnancies (95% CI 1.33-6.83, P = .007).
Maternal recall of stress during pregnancy was associated with lower iron stores at birth. High cord blood ZnPP/H, reflecting low erythrocyte iron, was correlated with the likelihood of stage 1 iron deficiency at 1 year, when rapid growth can deplete storage iron in breastfed infants.
探讨孕妇孕期压力对新生儿铁及 1 岁时铁缺乏 1 期的影响。
共有 245 名母亲及其新生儿（52%为男性；72%为白人）在 Meriter 医院分娩中心根据铁缺乏的已知危险因素入选。测定脐血血红蛋白和锌原卟啉/血红素（ZnPP/H）以评估红细胞铁，测定血浆铁蛋白以反映铁储存。母亲们使用 25 项问卷回顾性报告孕期经历的压力。还采集了 79 名 1 岁时母乳喂养婴儿的血液。
即使没有重大创伤事件，孕妇孕期的痛苦和健康担忧与脐血 ZnPP/H 指数相关（r=0.21，P<.01）。当与其他已知的铁缺乏危险因素（包括母亲肥胖、社会经济地位和种族）同时存在时，母体压力具有累积效应，降低脐血铁。1 岁时，24%母乳喂养的婴儿有中度铁缺乏（血浆铁蛋白<12μg/L）。较高的脐血 ZnPP/H 可预测这种中度铁缺乏（95%CI 0.26-1.47，P=0.007）。当与母亲报告的妊娠期压力同时存在时，与低压力妊娠相比，母乳喂养婴儿的低血浆铁蛋白在 1 岁时的发生可能性增加了 36 倍（95%CI 1.33-6.83，P=0.007）。
孕妇孕期压力回忆与出生时铁储量较低有关。高脐血 ZnPP/H，反映红细胞铁低，与 1 岁时铁缺乏 1 期的发生可能性相关，此时快速生长可能会耗尽母乳喂养婴儿的铁储存。
