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The effects of maternal iron deficiency on infant fibroblast growth factor-23 and mineral metabolism

V S Braithwaite1, A Prentice1, M K Darboe2

  • 1MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK and MRC Unit, The Gambia.

Bone
|October 11, 2015
PubMed

Insights

Maternal iron deficiency during pregnancy is linked to higher infant C-terminal FGF23 (C-FGF23) and total alkaline phosphatase (TALP) levels. This highlights the importance of preventing iron deficiency for infant health and development.

Area of Science:

  • Endocrinology
  • Nutritional Science
  • Pediatrics

Background:

  • Fibroblast growth factor-23 (FGF23) is a key hormone regulating phosphate metabolism.
  • Elevated FGF23 is associated with hypophosphatemic syndromes and predicts mortality in kidney disease.
  • Emerging evidence suggests iron deficiency may influence FGF23 expression, with potential in utero effects.

Purpose of the Study:

  • To investigate the impact of maternal iron status on infant FGF23 and mineral metabolites.
  • To assess FGF23, phosphate, total alkaline phosphatase, and hemoglobin levels in infants over the first two years of life.
  • To explore the relationship between maternal iron status and infant mineral metabolism markers.

Main Methods:

  • Analysis of blood and plasma samples from infants born to mothers with normal and low iron status during pregnancy.
  • Longitudinal assessment of intact-FGF23 (I-FGF23), C-terminal-FGF23 (C-FGF23), phosphate, total alkaline phosphatase (TALP), and hemoglobin (Hb) at multiple time points up to 104 weeks.
  • Statistical analysis to determine predictors of FGF23 concentrations and differences between maternal iron status groups.

Main Results:

  • Infant I-FGF23, phosphate, TALP, and Hb decreased over time, while estimated glomerular filtration rate increased.
  • Infants born to mothers with low iron status exhibited significantly higher C-FGF23 and TALP levels from 24-52 weeks onwards.
  • Infant hemoglobin was the strongest negative predictor of C-FGF23, and phosphate was the strongest positive predictor of I-FGF23.

Conclusions:

  • Poor maternal iron status is associated with elevated infant C-FGF23 and TALP, but not I-FGF23, in early childhood.
  • These findings underscore the public health significance of addressing iron deficiency during pregnancy.
  • Further research is needed to determine if these altered metabolite concentrations predispose children to impaired bone development or rickets.

Keywords:
AfricaBone healthEarly lifeFGF23Iron status in pregnancyPhosphate

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