Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
E.N.T. Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Matern Fetal Neonatal Med. 2020 Jun;33(11):1881-1888. doi: 10.1080/14767058.2018.1533940. Epub 2018 Nov 4.
Iron is crucial for fetal brain development; however, there are insufficient data regarding the effects of maternal iron deficiency anemia (IDA) on auditory neural maturation. We evaluated the effect of maternal IDA on auditory brainstem response (ABR) in full-term neonates. Out of 223 pregnant women, 50 were diagnosed as having IDA and 50 healthy mothers were enrolled as controls. ABR test was done for the studied neonates within 48 hours after birth and at 3 months. We found that hemoglobin and iron profile were lower in neonates born to anemic mothers compared with controls. Of 100 neonates screened for ABR, 25 failed the test (all of them were born to anemic mothers). The majority of neonates who failed the screening ABR test (88%) had latent iron deficiency (cord blood ferritin 11-75 µg/L). After 3 months, 85 neonates underwent diagnostic ABR test which revealed significantly prolonged interpeak latencies I-III, III-V, and I-V among neonates born to IDA mothers compared with the control group. Within the IDA group, all interpeak latencies were more prolonged in neonates with latent iron deficiency and in those born to mothers with serum ferritin <15 µg/L. Logistic regression analysis showed that maternal hemoglobin and mean corpuscular volume could predict neonatal ABR results. IDA during late pregnancy adversely affects cord blood iron and hearing status. ABR results are closely related to the severity of maternal and neonatal iron status. Antenatal screening of pregnant mothers is needed to improve fetal iron status and prevent abnormal auditory maturation.
铁对于胎儿大脑发育至关重要；然而，关于母体缺铁性贫血（IDA）对听觉神经成熟的影响的数据还不够充分。我们评估了母体 IDA 对足月新生儿听觉脑干反应（ABR）的影响。在 223 名孕妇中，有 50 名被诊断为 IDA，50 名健康母亲被纳入对照组。对研究中的新生儿在出生后 48 小时内和 3 个月时进行 ABR 测试。我们发现，与对照组相比，贫血母亲所生的新生儿的血红蛋白和铁谱较低。在接受 ABR 筛查的 100 名新生儿中，有 25 名（均为贫血母亲所生）测试失败。筛查 ABR 测试失败的大多数新生儿（88%）存在潜在缺铁（脐血铁蛋白 11-75μg/L）。3 个月后，85 名新生儿接受了诊断性 ABR 测试，结果显示，与对照组相比，IDA 母亲所生的新生儿的 I-III、III-V 和 I-V 峰间潜伏期明显延长。在 IDA 组中，所有峰间潜伏期在潜在缺铁的新生儿和血清铁蛋白<15μg/L 的母亲所生的新生儿中都更长。逻辑回归分析表明，母体血红蛋白和平均红细胞体积可以预测新生儿 ABR 结果。妊娠晚期 IDA 会对脐血铁和听力状况产生不利影响。ABR 结果与母体和新生儿铁状况的严重程度密切相关。需要对孕妇进行产前筛查，以改善胎儿铁状况并预防听觉成熟异常。
