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Effect of Severe Maternal Iron Deficiency Anemia on Neonatal Platelet Indices
Sriparna Basu1, Naveen Kumar2, Ragini Srivastava3
1The Neonatal Unit, Department of Pediatrics, Institure of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India. drsriparnabasu@rediffmail.com.
Insights
Maternal iron deficiency anemia (IDA) can impact fetal development. Severe IDA in mothers is linked to moderate thrombocytopenia (low platelets) and increased platelet distribution width (PDW) in newborns.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Hematology
Background:
- Iron deficiency anemia (IDA) is a common complication during pregnancy.
- Maternal IDA can potentially affect fetal hematopoiesis, including thrombopoiesis.
- Understanding these effects is crucial for fetal well-being and management.
Purpose of the Study:
- To investigate the impact of maternal IDA on fetal thrombopoiesis.
- To analyze cord blood platelet indices in neonates born to mothers with varying degrees of IDA.
Main Methods:
- A prospective observational study included 142 mothers with IDA and 142 healthy controls.
- Maternal and cord blood iron status and platelet indices (absolute platelet count, mean platelet volume, platelet distribution width, plateletcrit) were measured.
- Exclusion criteria included maternal infections, hypertension, and neonatal complications.
Main Results:
- Neonates from mothers with severe IDA exhibited significantly lower cord blood absolute platelet counts and increased platelet distribution width.
- Mild-to-moderate IDA did not show significant differences in these platelet indices compared to controls.
- Mean platelet volume and plateletcrit remained comparable across groups.
Conclusions:
- Severe maternal IDA is associated with moderate thrombocytopenia and altered platelet indices in newborns.
- Further research is needed to elucidate the mechanisms and clinical implications of these findings.
Objective:
To evaluate the effect of maternal iron deficiency anemia (IDA) on fetal thrombopoiesis.
Methods:
In this prospective observational study, maternal and cord blood iron status parameters (serum iron, serum ferritin, total iron-binding capacity, and transferrin saturation), and platelet indices, such as, absolute platelet count (APC), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit, were estimated in a convenient sample of 142 mothers with IDA (hemoglobin <11 g/dl and serum ferritin <12 ng/ml) and an equal number of healthy non-anemic (hemoglobin ≥11 g/dl) mothers, who delivered singleton live neonates at term gestation. Mothers with antenatal thrombocytopenia, infections, inflammatory conditions, pregnancy-induced hypertension and neonates with perinatal asphyxia, sepsis and congenital malformations were excluded.
Results:
For statistical analysis, the IDA group was further subdivided into mild-to-moderate (hemoglobin 7-10.9 g/dl) and severe (hemoglobin <7 g/dl) anemia. Cord blood APC and PDW were comparable between non-anemic and mild-to-moderate anemic mothers (242,550 ± 54,320/μL vs. 235,260 ± 34,620/μL for APC and 16.2 ± 1.4 vs. 16.4 ± 1.8 fl for PDW, respectively), but in severe IDA group, cord blood APC and PDW were significantly lower (74,520 ± 12,380/μL and 17.8 ± 2.1 fl, respectively, p < 0.001). MPV and plateletcrit were comparable. None of the study neonates had a platelet count <30,000/μL or showed any evidence of clinical bleeding.
Conclusions:
Neonates born to mothers with severe IDA had moderate thrombocytopenia with increased PDW, though no change was observed in MPV and plateletcrit. Further studies should be carried out to identify the cause and consequences of this observation.
