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Maternal Adiposity and Inflammation: Risk Factors for Iron Deficiency in Pregnancy.

Sabrina P Demirdjian1, Maria S Mulhern1, Maeve A Kerr1

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The Journal of Nutrition
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Maternal obesity and inflammation increase the risk of iron deficiency (ID) in late pregnancy. Early pregnancy soluble transferrin receptor (sTfR) effectively predicts this risk, especially in overweight or obese individuals.

Keywords:
anemiabody fatgravidityhypoferremiainterleukinsiron depletioniron markersiron statusprenatal carevisceral fat

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Area of Science:

  • Obstetrics and Gynecology
  • Nutritional Science
  • Maternal-Fetal Medicine

Background:

  • Obesity and iron deficiency (ID) are significant global health issues during pregnancy, posing risks to both mother and child.
  • The relationship between obesity-induced inflammation and the development of ID or anemia in pregnant individuals remains unclear.

Purpose of the Study:

  • To investigate the association between maternal adiposity, inflammation, and iron status during pregnancy.
  • To determine if maternal adiposity influences the predictive accuracy of early pregnancy iron markers for late pregnancy ID risk.

Main Methods:

  • Secondary analysis of a randomized controlled trial involving singleton pregnancies receiving iron-fortified multivitamins.
  • Assessment of body mass index (BMI), body composition, iron markers, and hemoglobin levels at multiple gestational weeks (GW).
  • Calculation of an inflammation score using pro-inflammatory cytokines to categorize participants as high or low inflammation.

Main Results:

  • Higher BMI and fat mass index at 12 GW were associated with lower ferritin levels at 36 GW and higher soluble transferrin receptor (sTfR) levels.
  • Women with obesity exhibited lower transferrin saturation at 12 and 28 GW compared to normal weight individuals.
  • At 36 GW, pregnant women with obesity and higher inflammation scores had significantly lower ferritin levels.
  • Early pregnancy sTfR (12 GW) was the strongest predictor of ID at 36 GW, particularly in overweight and obese women.

Conclusions:

  • Elevated maternal adiposity, potentially mediated by inflammation, significantly increases the risk of iron deficiency in the third trimester of pregnancy.
  • Soluble transferrin receptor (sTfR) measured in early pregnancy is a reliable predictor of late pregnancy iron deficiency.