Association between maternal anemia and cord blood hemoglobin and ferritin concentrations in newborns: a...

The purpose of this study was to evaluate the effect of third-trimester maternal iron deficiency and iron deficiency anemia on neonatal cord-blood hemoglobin (Hgb), and serum ferritin levels.

Pregnant women who gave birth between 37^0/7 and 40^6/7 weeks of gestation, and their neonates were included. Maternal hemoglobin and ferritin levels were assessed. They were divided into two groups based on Hgb values as anemic and non-anemic. Furthermore, the anemic group was classified as mild, moderate, and severe anemia. Maternal and cord Hgb, hematocrit and ferritin levels were compared between groups. The study population was stratified into two groups according to iron supplementation status.

Among 627 women included, 226(36%) were diagnosed as anemic, of which 130(57.5%) had mild, 94(41.6%) moderate, and 2(0.9%) severe anemia. Mean maternal Hb levels were 9.9±0.9 g/dl and 12.1±0.9 g/dl in the anemic and non-anemic groups, respectively. The mean maternal serum ferritin of anemic and non-anemic mothers were 11.7 ng/ml and 15.8 ng/ml, respectively (p < 0.001). The mean cord-blood serum ferritin of neonates born from anemic and non-anemic mothers was 113±68.8 ng/ml and 134±95.0 ng/ml, respectively (p = 0.012). Cord-blood Hb levels of neonates born from anemic and non-anemic mothers were 15.1±1.8 g/dl and 15.5±2.0 g/dl, respectively (p = 0.006). The 5th, 25th, 50th, 75th, and 95th percentiles of cord blood serum ferritin concentrations were 32.6, 72.2, 107.5, 154.1, and 272.6 ng/ml, respectively. Among neonates born from mild, moderate, and severe anemic mothers, there was no significant difference regarding cord-blood serum ferritin and blood count parameters (p > 0.05). Cord-blood serum ferritin concentrations were found to be 119 ± 85.7 ng/ml and 136.4 ± 87.9 ng/ml in the low and normal maternal serum ferritin groups, respectively (p = 0.015).

Maternal anemia is common and associated with lower neonatal cord blood hemoglobin and ferritin levels. However, lack of iron supplementation during pregnancy, rather than anemia itself, was the strongest independent predictor of neonatal anemia. These findings highlight the importance of routine antenatal iron supplementation to support fetal iron status and improve perinatal outcomes. Further randomized controlled trials are needed to evaluate the effects of maternal iron supplementation on fetal iron stores and long-term outcomes.