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An assessment of cord ferritin concentration and its predictors among a cohort of Canadian preterm and term infants

Published online by Cambridge University Press:  02 January 2025

Lulu X. Pei Open the ORCID record for Lulu X. Pei [Opens in a new window] ,
Jennifer A. Hutcheon  and
Crystal D. Karakochuk
Lulu X. Pei
Affiliation:
Food, Nutrition and Health, The University of British Columbia, Vancouver, Canada Healthy Starts, BC Children’s Hospital Research Institute, Vancouver, Canada
Jennifer A. Hutcheon
Affiliation:
Healthy Starts, BC Children’s Hospital Research Institute, Vancouver, Canada Obstetrics and Gynaecology, The University of British Columbia, Vancouver, Canada
Crystal D. Karakochuk*
Affiliation:
Food, Nutrition and Health, The University of British Columbia, Vancouver, Canada Healthy Starts, BC Children’s Hospital Research Institute, Vancouver, Canada
*
Corresponding author: Crystal D. Karakochuk; Email: [email protected]
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Abstract

Low iron (Fe) stores at birth may adversely influence child cognitive and motor development. The aims of this study were to assess cord blood Fe levels and explore maternal and neonatal factors associated with Fe status. Cord blood specimens (n 46) were obtained from the BC Children’s Hospital BioBank in Vancouver, Canada. The primary outcome was cord plasma ferritin, measured using sandwich-ELISA. Predictors of interest included maternal age, gestational age, gravidity, infant sex, birth weight and delivery method. Median (interquartile range (IQR)) maternal age and gestational age at delivery was 33·5 (29·3–35·8) years and 36·5 (30·0–39·0) weeks, respectively, and 44 % of infants were female. Median (IQR) cord ferritin was 100·4 (75·7–128·9) µg/l, and 26 % had low Fe status (ferritin <76 µg/l). Among preterm deliveries, a 1-week increase in gestational age was associated with a 6·22 (95 % CI (1·10, 9·52)) µg/l increase in median cord ferritin. However, among term deliveries, a negative trend was observed (–2·38 µg/l per week of gestation (95 % CI (–34·8, 0·78))), indicating a potential non-linear relationship between gestational age and cord ferritin. Female term infants had higher cord ferritin compared with males (β (95 % CI): 30·3 (18·4, 57·9) µg/l), suggesting sex-specific differences in Fe transfer, acquisition and utilisation. Cord ferritin was higher with vaginal deliveries compared with caesarean sections (β (95 % CI): 39·1 (29·0, 51·5) µg/l). Low Fe status may be a concern among infants in Canada; however, further research is needed to inform appropriate thresholds to define optimal Fe status in cord blood.

Keywords

Cord bloodInfant Fe statusFe deficiencyPregnancyFerritin
Type
Research Article
Information
British Journal of Nutrition , First View , pp. 1 - 6
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Gibson, R (2005) Principles of Nutritional Assessment, 2nd edition. New York: Oxford University Press.Google Scholar
Radlowski, E & Johnson, R (2013) Perinatal iron deficiency and neurocognitive development. Front Hum Neurosci 7, 585.Google Scholar
Cochrane, KM, Hutcheon, JA & Karakochuk, CD (2022) Iron-deficiency prevalence and supplementation practices among pregnant women: a secondary data analysis from a clinical trial in Vancouver, Canada. J Nutr 152, 2238–2244.Google Scholar
Tamura, T, Goldenberg, RL, Hou, J, et al. (2002) Cord serum ferritin concentrations and mental and psychomotor development of children at five years of age. J Pediatr 140, 165–170.Google Scholar
Milman, N, Ibsen, KK & Christensen, JM (1987) Serum ferritin and iron status in mothers and newborn infants. Acta Obstet Gynecol Scand 66, 205–211.Google Scholar
MacPhail, AP, Charlton, RW, Bothwell, TH, et al. (1980) The relationship between maternal and infant iron status. Scand J Haematol 25, 141–150.Google Scholar
Shao, J, Lou, J, Rao, R, et al. (2012) Maternal serum ferritin concentration is positively associated with newborn iron stores in women with low ferritin status in late pregnancy. J Nutr 142, 2004–2009.Google Scholar
Kumar, A, Rai, AK, Basu, S, et al. (2008) Cord blood and breast milk iron status in maternal anemia. Pediatr 121, e673–e7.Google Scholar
Akhter, S, Momen, MA, Rahman, MM, et al. (2010) Effect of maternal anemia on fetal outcome. Mymensingh Med J 19, 391–398.Google Scholar
Georgieff, MK, Wewerka, SW, Nelson, CA, et al. (2002) Iron status at 9 months of infants with low iron stores at birth. J Pediatr 141, 405–409.Google Scholar
Hay, G, Refsum, H, Whitelaw, A, et al. (2007) Predictors of serum ferritin and serum soluble transferrin receptor in newborns and their associations with iron status during the first 2 y of life. Am J Clin Nutr 86, 64–73.Google Scholar
Erhardt, JG, Estes, JE, Pfeiffer, CM, et al. (2004) Combined measurement of ferritin, soluble transferrin receptor, retinol binding protein, and C-reactive protein by an inexpensive, sensitive, and simple sandwich enzyme-linked immunosorbent assay technique. J Nutr 134, 3127–3132.Google Scholar
Siddappa, AM, Georgieff, MK, Wewerka, S, et al. (2004) Iron deficiency alters auditory recognition memory in newborn infants of diabetic mothers. Pediatr Res 55, 1034–1041.Google Scholar
Koenker, R (2005) Quantile Regression. Cambridge: Cambridge University Press.Google Scholar
Rao, R & Georgieff, MK (2007) Iron in fetal and neonatal nutrition. Semin Fetal Neonatal Med 12, 54–63.Google Scholar
Lorenz, L, Peter, A, Poets, CF, et al. (2013) A review of cord blood concentrations of iron status parameters to define reference ranges for preterm infants. Neonatology 104, 194–202.Google Scholar
Siddappa, AM, Rao, R, Long, JD, et al. (2007) The assessment of newborn iron stores at birth: a review of the literature and standards for ferritin concentrations. Neonatology 92, 73–82.Google Scholar
Delaney, KM, Guillet, R, Fleming, RE, et al. (2019) Umbilical cord serum ferritin concentration is inversely associated with umbilical cord hemoglobin in neonates born to adolescents carrying singletons and women carrying multiples. J Nutr 149, 406–415.Google Scholar
Tamura, T, Hou, J, Goldenberg, RL, et al. (1999) Gender difference in cord serum ferritin concentrations. Biol Neonate 75, 343–349.Google Scholar
Larsson, SM, Hillarp, A, Hellström-Westas, L, et al. (2019) When age really matters; ferritin reference intervals during infancy revisited. Scand J Clin Lab Invest 79, 590–594.Google Scholar
Evanchuk, JL, Kozyrskyj, A, Hanas, N, et al. (2023) Maternal iron status is dynamic throughout pregnancy and might predict birth outcomes in a sex dependent manner: results from the alberta pregnancy outcomes and nutrition (APrON) cohort study. J Nutr 153, 2585–2597.Google Scholar
Dumrongwongsiri, O, Winichagoon, P, Chongviriyaphan, N, et al. (2021) Effect of maternal nutritional status and mode of delivery on zinc and iron stores at birth. Nutrients 13, 860.Google Scholar
McCarthy, E, Kenny, L, Hourihane, J, et al. (2017) Impact of maternal, antenatal and birth-associated factors on iron stores at birth: data from a prospective maternal–infant birth cohort. Eur J Clin Nutr 71, 782–787.Google Scholar
Zhou, Y, Li, H, Zhu, L, et al. (2014) Impact of cesarean section on placental transfusion and iron-related hematological indices in term neonates: a systematic review and meta-analysis. Placenta 35, 1–8.Google Scholar