Tao Yun, Kang Jiawei, Liu Juan, Duan Jie, Wang Fang, Shi Yue, Li Yujuan, Wang Cheng, Xu Dan, Qu Xinlan, Guo Juanjuan, Ma Jianhong, Zhang Yuanzhen
Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, China.
Front Nutr. 2022 Oct 10;9:1002702. doi: 10.3389/fnut.2022.1002702. eCollection 2022.
Birthweight have profound impacts on health status throughout lifetime, however, the relationship between maternal ferritin level in pregnancy and birthweight of the newborn remains controversial.
This retrospective cohort research was to analyze the association between maternal ferritin levels during pregnancy with birthweight outcomes, primarily for low birthweight (LBW) and small for gestational age (SGA).
Newborns weighing lower than 2,500 grams were defined as LBW. SGA is defined as birthweight lower than the 10 percentile of the distribution of newborns' birthweight of the same gestational age. Multivariable logistic regressions have been used to explore the association of maternal ferritin levels and birthweight related outcomes, in which the ferritin concentration was logarithm transformed in the model. We further used restricted cubic spline models to explore linear/non-linear dose-response manners of ferritin level and birthweight outcomes.
A total of 3,566 pregnant women were included in the study. In the results of the present study, we observed that maternal ferritin levels were linearly associated with the risk of LBW (trend = 0.005) and SGA (trend = 0.04), with the adjusted odds ratios (ORs) of 1.78 (95% CI 1.37-2.32) for LBW and 1.87 (95% CI 1.38-2.54) for SGA with an increase in Ln-ferritin concentrations per unit. The adjusted ORs across quartiles of ferritin levels were 2.14 (95% CI 1.03-4.47) for Quartile 2, 3.13 (95% CI 1.47-6.69) for Quartile 3, and 3.63 (95% CI 1.52-8.68) for Quartile 4 for LBW. The adjusted ORs of LBW and SGA among women using supplemental iron were 0.56 (95% CI 0.38, 0.85) and 0.65 (95% CI 0.40, 1.05) compared with non-users, respectively.
Our findings found a linear dose-response relationship between ferritin levels and an increased risk of poor birthweight outcomes, suggesting that maternal ferritin level during pregnancy may provide an additional predictor for differentiating poor birthweight related outcomes. Further exploration should be conducted to ensure maternal ferritin thresholds and iron supplement doses.
出生体重对一生的健康状况有深远影响，然而，孕期母体铁蛋白水平与新生儿出生体重之间的关系仍存在争议。
这项回顾性队列研究旨在分析孕期母体铁蛋白水平与出生体重结局之间的关联，主要针对低出生体重（LBW）和小于胎龄儿（SGA）。
体重低于2500克的新生儿被定义为低出生体重儿。小于胎龄儿定义为出生体重低于同孕周新生儿出生体重分布的第10百分位数。采用多变量逻辑回归来探讨母体铁蛋白水平与出生体重相关结局的关联，其中铁蛋白浓度在模型中进行对数转换。我们进一步使用受限立方样条模型来探讨铁蛋白水平与出生体重结局的线性/非线性剂量反应关系。
本研究共纳入3566名孕妇。在本研究结果中，我们观察到母体铁蛋白水平与低出生体重风险（趋势=0.005）和小于胎龄儿风险（趋势=0.04）呈线性相关，每单位铁蛋白浓度对数增加时，低出生体重的调整优势比（OR）为1.78（95%CI 1.37 - 2.32），小于胎龄儿为1.87（95%CI 1.38 - 2.54）。铁蛋白水平四分位数的低出生体重调整OR分别为：第二四分位数2.14（95%CI 1.03 - 4.47），第三四分位数3.13（95%CI 1.47 - 6.69），第四四分位数3.63（95%CI 1.52 - 8.68）。与未使用补充铁剂的女性相比，使用补充铁剂的女性中低出生体重和小于胎龄儿的调整OR分别为：0.56（95%CI 0.38, 0.85）和0.65（CI 0.40, 1.05）。
我们的研究结果发现铁蛋白水平与不良出生体重结局风险增加之间存在线性剂量反应关系，这表明孕期母体铁蛋白水平可能为区分不良出生体重相关结局提供额外的预测指标。应进一步探索以确定母体铁蛋白阈值和铁补充剂剂量。
