Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Peking University First Hospital, Beijing, China.
J Nutr. 2021 Aug 7;151(8):2296-2304. doi: 10.1093/jn/nxab133.
Overweight or obesity among pregnant women may compromise maternal and neonatal iron status by upregulating hepcidin.
This study determined the association of 1) maternal and neonatal iron status with maternal and neonatal hepcidin concentrations, and 2) maternal prepregnancy weight status with maternal and neonatal hepcidin concentrations.
We examined hematologic data from 405 pregnant women and their infants from the placebo treatment group of a pregnancy iron supplementation trial in rural China. We measured hepcidin, serum ferritin (SF), soluble transferrin receptor (sTfR), and high-sensitivity C-reactive protein in maternal blood samples at mid-pregnancy and in cord blood at delivery. We used regression analysis to examine the association of maternal prepregnancy overweight or obese status with maternal hepcidin concentration in mid-pregnancy and cord hepcidin concentrations. We also used path analysis to examine mediation of the association of maternal prepregnancy overweight or obese status with maternal iron status by maternal hepcidin, as well as with neonatal hepcidin by neonatal iron status.
Maternal iron status was positively correlated with maternal hepcidin at mid-pregnancy (SF: r = 0.63, P < 0.001; sTfR: r = -0.37, P < 0.001). Neonatal iron status was also positively correlated with cord hepcidin (SF: r = 0.61, P < 0.001; sTfR: r = -0.39, P < 0.001). In multiple linear regression models, maternal prepregnancy overweight or obese status was not associated with maternal hepcidin at mid-pregnancy but was associated with lower cord hepcidin (coefficient = -0.21, P = 0.004). Using path analysis, we observed a significant indirect effect of maternal prepregnancy overweight or obese status on cord hepcidin, mediated by neonatal iron status.
In both pregnant women and neonates, hepcidin was responsive to iron status. Maternal prepregnancy overweight status, with or without including obese women, was associated with lower cord blood hepcidin, likely driven by lower iron status among the neonates of these mothers.
孕妇超重或肥胖可能通过上调铁调素而损害母婴铁状态。
本研究旨在确定 1）母婴铁状态与母婴铁调素浓度的关系，以及 2）孕妇孕前体重状况与母婴铁调素浓度的关系。
我们检测了来自中国农村一项妊娠补铁试验安慰剂治疗组的 405 名孕妇及其婴儿的血液学数据。我们在孕妇妊娠中期和分娩时的脐血中测量了铁调素、血清铁蛋白（SF）、可溶性转铁蛋白受体（sTfR）和高敏 C 反应蛋白。我们采用回归分析来检测孕妇孕前超重或肥胖状况与妊娠中期母血铁调素浓度和脐血铁调素浓度的关系。我们还采用路径分析来检测母孕期超重或肥胖状况通过母血铁调素对母婴铁状态的间接影响，以及通过新生儿铁状态对新生儿铁调素的间接影响。
孕妇铁状态与妊娠中期母血铁调素呈正相关（SF：r=0.63，P<0.001；sTfR：r=-0.37，P<0.001）。新生儿铁状态也与脐血铁调素呈正相关（SF：r=0.61，P<0.001；sTfR：r=-0.39，P<0.001）。在多元线性回归模型中，孕妇孕前超重或肥胖状况与妊娠中期母血铁调素无关，但与脐血铁调素较低相关（系数=-0.21，P=0.004）。通过路径分析，我们观察到孕妇孕前超重或肥胖状况对脐血铁调素的显著间接影响，这是通过新生儿铁状态介导的。
在孕妇和新生儿中，铁调素对铁状态均有反应。孕妇孕前超重状况，无论是否包括肥胖，均与脐血铁调素水平较低有关，这可能是由于这些孕妇的新生儿铁状态较低所致。
