Sun Peng, Zhou Yueqin, Xu Suhua, Wang Xiaotong, Li Xiuxiu, Li Hailin, Lin Zongyu, Huang Fenglian, Zhu Lewei, Zhu Yanna
Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China.
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Front Nutr. 2023 Aug 15;10:1147114. doi: 10.3389/fnut.2023.1147114. eCollection 2023.
Iron deficiency (ID) and iron deficiency anemia (IDA) during pregnancy are highly prevalent worldwide. Hepcidin is considered an important biomarker of iron status. Currently, few longitudinal cohort studies have assessed the potential causal relationship between hepcidin and ID/IDA. Therefore, we aimed to investigate the association of first-trimester maternal serum hepcidin with third-trimester ID/IDA risk in a prospective cohort.
Total of 353 non-ID/IDA pregnant women at 11-13 weeks' gestation were enrolled in Southern China and followed up to 38 weeks of gestation. Data on demography and anthropometry were obtained from a structured questionnaire at enrollment. Iron biomarkers including hepcidin were measured at enrollment and follow-up. Regression models were used to evaluate the association of first-trimester hepcidin with third-trimester ID/IDA risk.
Serum hepcidin levels substantially decreased from 19.39 ng/mL in the first trimester to 1.32 ng/mL in the third trimester. Incidences of third-trimester ID and IDA were 46.2 and 11.4%, respectively. Moreover, moderate and high levels of first-trimester hepcidin were positively related to third-trimester hepcidin (log-transformed = 0.51; 95% CI = 0.01, 1.00 and log-transformed = 0.66; 95% CI = 0.15, 1.17). Importantly, elevated first-trimester hepcidin was significantly associated with reduced risk of third-trimester IDA (OR = 0.38; 95% CI = 0.15, 0.99), but not with ID after adjustment with potential confounders.
First-trimester hepcidin was negatively associated with IDA risk in late pregnancy, indicating higher first-trimester hepcidin level may predict reduced risk for developing IDA. Nonetheless, given the limited sample size, larger studies are still needed.
孕期缺铁（ID）和缺铁性贫血（IDA）在全球范围内高度流行。铁调素被认为是铁状态的重要生物标志物。目前，很少有纵向队列研究评估铁调素与ID/IDA之间的潜在因果关系。因此，我们旨在在前瞻性队列中研究孕早期母体血清铁调素与孕晚期ID/IDA风险的关联。
在中国南方招募了353名孕11 - 13周的非ID/IDA孕妇，并随访至孕38周。人口统计学和人体测量学数据通过入组时的结构化问卷获得。在入组和随访时测量包括铁调素在内的铁生物标志物。使用回归模型评估孕早期铁调素与孕晚期ID/IDA风险的关联。
血清铁调素水平从孕早期的19.39 ng/mL大幅降至孕晚期的1.32 ng/mL。孕晚期ID和IDA的发生率分别为46.2%和11.4%。此外，孕早期铁调素的中高水平与孕晚期铁调素呈正相关（对数转换后 = 0.51；95%CI = 0.01，1.00和对数转换后 = 0.66；95%CI = 0.15，1.17）。重要的是，孕早期铁调素升高与孕晚期IDA风险降低显著相关（OR = 0.38；95%CI = 0.15，0.99），但在调整潜在混杂因素后与ID无关。
孕早期铁调素与妊娠晚期IDA风险呈负相关，表明孕早期铁调素水平较高可能预示着发生IDA的风险降低。尽管如此，鉴于样本量有限，仍需要更大规模的研究。
