Sub-optimal fetal iron acquisition under a maternal environment

Iron deficiency acquired at an early age can lead to significant developmental alterations. To evaluate the need for an interventional trial, we determined the iron reserves of neonates born to a group of women from an urban disadvantaged group. The influence of maternal iron on newborn hemoglobin, birth weight, and height was also analyzed. Hemoglobin and serum ferritin (SF) concentrations were measured at delivery on 201 neonates and their mothers. Neonatal iron stores were considered deficient when the cord SF concentration was <12.0 microg/L, reduced if > or =12.0 but <30 microg/L, and replenished when > or =30 microg/L. The same cut-offs applied to maternal SF values. Cord SF in the study group was 81.2 +/- 63 microg/L. Following the criteria adopted for this study, three groups of neonates were identified. I: 13 (6.5%) were born with deficient iron stores, II: 15 (7.5%) had reduced iron stores, and III: 173 (86%) had normal levels of storage iron. Cord SF concentrations were 7.1 +/- 3.5, 19.9 +/- 4.4 and 92 +/- 60 microg/L, respectively. Cord hemoglobin did not differ among groups. Iron stores at birth were reduced when maternal stores were deficient, reflecting a limited fetal iron-acquisition capacity and the restrictive effect of gestational iron deficiency on the constitution of adequate fetal iron reserves. These findings support the need for an interventional trial on the study population. Hemoglobin, birth weight, and height did not correlate with fetal or maternal iron stores.