Iron infusion in pregnancy and dental dysplasia in children-is there a link?

Area of Science:

• Obstetrics and Gynecology
• Pediatric Dentistry
• Endocrinology

Background:

• Intravenous iron formulations can induce hypophosphatemia via fibroblast growth factor 23 (FGF23).
• Maternal hypophosphatemia during pregnancy may affect fetal tooth mineralization, which begins mid-gestation.
• Fetal development necessitates adequate calcium and phosphate for bone and tooth mineralization.

Purpose of the Study:

• To hypothesize a potential link between intravenous iron-induced maternal hypophosphatemia and fetal dental dysplasia.
• To highlight the need for research into the long-term clinical impact of maternal hypophosphatemia on fetal development.
• To emphasize the importance of interdisciplinary collaboration for studying these effects.

Main Methods:

• This study is primarily a hypothesis-driven review and discussion.
• It draws parallels with known associations between hypophosphatemia and dental issues in conditions like X-linked hypophosphatemic rickets.
• It calls for prospective studies to investigate the effects.

Main Results:

• Hypophosphatemia induced by intravenous iron may impair primary and permanent tooth mineralization.
• Calcium and phosphate deficiency, prioritized for bone, could compromise tooth development.
• The long-term clinical impact on fetal development remains under-investigated.

Conclusions:

• Maternal hypophosphatemia from intravenous iron infusion is a potential risk factor for dental dysplasia in offspring.
• Further research is crucial to confirm this association and its clinical significance.
• Collaboration among obstetricians, pediatric dentists, and pediatricians is essential for comprehensive evaluation.