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Maternal iron status during early pregnancy and school-age, lung function, asthma, and allergy: The Generation R
Hugo G Quezada-Pinedo1,2, Sara M Mensink-Bout1,3, Irwin K Reiss2
1The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Insights
Maternal iron status during pregnancy impacts child allergy risk. Higher transferrin levels in mothers were linked to increased physician-diagnosed inhalant allergies in children, but not lung function or asthma.
Area of Science:
- Perinatal Medicine
- Pediatric Allergy & Immunology
- Nutritional Epidemiology
Background:
- Early life iron deficiency can negatively impact lung and immune system development.
- This may influence respiratory and allergy outcomes later in childhood.
Purpose of the Study:
- To investigate the association between maternal iron status in early pregnancy and child's lung function.
- To examine links with childhood asthma, allergic sensitization, and physician-diagnosed inhalant allergy at school age.
Main Methods:
- Population-based cohort study of 3825 mother-child pairs.
- Maternal serum ferritin, transferrin, and transferrin saturation measured in early pregnancy.
- Child outcomes (lung function, asthma, allergy) assessed at age 10 via spirometry, questionnaires, and skin prick tests.
Main Results:
- Higher maternal transferrin concentration was associated with increased risk of physician-diagnosed inhalant allergy (OR 1.13 [1.01-1.26]).
- No significant associations were found between maternal iron status markers and child's lung function, asthma, or allergic sensitization.
- Maternal ferritin and transferrin saturation showed no consistent associations with child respiratory or allergy outcomes.
Conclusions:
- Elevated maternal transferrin concentrations in pregnancy, indicating lower iron levels, correlate with a higher likelihood of physician-diagnosed inhalant allergy in offspring.
- The underlying biological mechanisms and clinical significance of this finding warrant further investigation.
Background:
Iron deficiency during early life could affect the developing lung and immune system, and influence child's respiratory or allergy outcomes in later life.
Objective:
To examine the associations of maternal iron status during early pregnancy with child's lung function, asthma, inhalant allergic sensitization, and physician-diagnosed inhalant allergy at school-age.
Methods:
In a population-based cohort study, among 3825 mother-child pairs, ferritin, transferrin concentrations, and transferrin saturation were measured from maternal venous blood samples during early pregnancy. In children at the age of 10 years, spirometry was used to determine child's lung function, current asthma and physician-diagnosed inhalant allergy were assessed by questionnaires, and inhalant allergic sensitization was measured by skin prick tests. We used multivariable regression models to examine the associations.
Results:
After adjustment for gestational age at maternal iron status measurement and sociodemographic or lifestyle-related confounders, a higher maternal transferrin concentration was associated with a higher risk of physician-diagnosed inhalant allergy (odds ratio [95% confidence interval]: 1.13 [1.01 to1.26]), but not with lung function, asthma, or inhalant allergic sensitization. This association did not attenuate after further adjustment for maternal hemoglobin levels or early growth factors. We observed no consistent association of maternal ferritin concentrations or transferrin saturation with child's respiratory or allergy outcomes.
Conclusion:
Higher maternal transferrin concentrations during pregnancy, reflecting lower serum iron levels, were associated with an increased risk of child's physician-diagnosed inhalant allergy but not lung outcomes. Underlying mechanisms and clinical implications need to be explored.
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