Maternal Perceived Stress during Pregnancy Increases Risk for Low Neonatal Iron at Delivery and Depletion of Storage Iron at One Year.
Maternal Perceived Stress during Pregnancy Increases Risk for Low Neonatal Iron at Delivery and Depletion of Storage Iron at One Year.
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DOI：
10.1016/j.jpeds.2018.04.040
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Kling PJ
中科院分区：
文献类型：
--
作者：
Rendina DN;Blohowiak SE;Coe CL;Kling PJ
目的探讨孕期母体应激对新生儿铁及一岁时1期铁缺乏症的影响。245名母亲及其新生儿(男性52%，白人72%)在梅里特医院分娩中心接受调查，测定脐带血(CB)、血红蛋白(Hb)和锌原卟啉/血红素(ZnPP/H)以评估红细胞铁，血浆铁蛋白(FERR)以反映储存铁。母亲们在一份包含25个项目的问卷中回顾了以前在怀孕期间经历的压力。还采集了一岁时79名母乳喂养的婴儿的血液。即使在没有重大创伤事件的情况下，母亲对怀孕期间痛苦和健康问题的回忆也与CB ZnPP/H指数相关(r=0.21，P<；.01)。当母亲应激与其他已知的ID风险同时发生时，包括母亲肥胖、SES和种族，母亲的压力具有终结性作用，降低了Cb铁。一岁时，24%的母乳喂养婴儿患有中度胰岛素抵抗(FERR<；12μg/L)。较高的CBZPP/H预示着中度ID(95%CI：0.26，1.47，p=0.007)。当与母亲关于妊娠压力的报告一致时，母乳喂养婴儿一年内出现低FERR的可能性是低压力妊娠的36倍([95%CI：1.33，6.83]，p=.007)。母亲对怀孕期间压力的回忆与出生时铁含量较低有关。反映低红细胞铁的高CbZPP/H与1岁时发生IID的可能性相关，此时母乳喂养婴儿的快速生长会耗尽储存的铁。
To investigate the impact of maternal stress during pregnancy on newborn iron and Stage 1 iron deficiency (ID) at one year of age. 245 mothers and their newborn infants (52% male; 72% white) were recruited at the Meriter Hospital Birthing Center on the basis of known risk factors for ID. Umbilical cord blood (CB) hemoglobin (Hb) and zinc protoporphyrin/heme (ZnPP/H) were determined to evaluate erythrocyte iron; plasma ferritin (Ferr) to reflect storage iron. Mothers retrospectively reported stress experienced previously during pregnancy on a 25-item questionnaire. Blood was also collected from 79 breastfed infants at one year of age. Maternal recall of distress and health concerns during pregnancy correlated with CB ZnPP/H indices (r=0.21, P < .01), even in the absence of major traumatic events. When concurrent with other known risks for ID, including maternal adiposity, SES and race, maternal stress had a summative effect, lowering CB iron. At one year, 24% of breastfed infants had moderate ID (Ferr <12 μg/L). Higher CB ZnPP/H was predictive of this moderate ID ([95%CI: 0.26, 1.47], p=.007). When coincident with maternal reports of gestational stress, the likelihood of low Ferr at one year increased 36-fold in breastfed infants as compared with low stress pregnancies ([95%CI: 1.33, 6.83], p=.007). Maternal recall of stress during pregnancy was associated with with lower iron stores at birth. High CB ZnPP/H, reflecting low erythrocyte iron, was correlated with the likelihood of Stage 1 ID at one year, when rapid growth can deplete storage iron in breastfed infants.
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