Cord blood and breast milk iron status in maternal anemia
Cord blood and breast milk iron status in maternal anemia
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DOI：
10.1542/peds.2007-1986
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发表时间：
2008-03-01
期刊：
影响因子：
8
通讯作者：
Singh, Jamuna Saran
中科院分区：
文献类型：
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作者：
Kumar, Ashok;Rai, Arun Kumar;Singh, Jamuna Saran
目标。本研究旨在探讨重度缺铁性贫血孕妇营养状况对脐带血和母乳铁含量的影响。我们在印度中部的一家教学医院进行了为期6个月的前瞻性观察研究。研究人群包括55名贫血（血红蛋白：< 110 g/L）和20名健康的非贫血（血红蛋白：< 110 g/L）孕妇，她们在足月妊娠期间分娩了一胎活产。我们测量了配对母血和脐带血中的血红蛋白、铁和铁蛋白水平，以及过渡乳早期（第3天+/- 1）和晚期（第15天+/- 3）的铁水平。记录产妇的人体测量，包括体重、身高、中臂围、三头肌皮褶厚度和胎盘重量。本研究的主要结局指标是发现母体血红蛋白、铁、铁蛋白和人体测量与脐带血血红蛋白、铁、铁蛋白和母乳铁水平的关系。血红蛋白、铁和铁蛋白的浓度在贫血母亲的脐带血中显著降低，并与母亲血红蛋白和铁蛋白水平呈线性关系。严重贫血母亲的母乳铁含量显著降低，而轻度至中度贫血母亲的母乳铁含量则没有显著降低。母乳铁水平与母体血红蛋白和铁水平相关，但与铁蛋白水平无关。母体人体测量与母体和脐带血铁营养指标有显著相关性，但与母乳铁含量无显著相关性。胎盘重量在贫血母亲和非贫血母亲之间具有可比性。产妇贫血，特别是重度贫血，会对脐带血和母乳中的铁含量产生不利影响。母体营养状况对胎儿铁含量有显著影响，但对母乳铁含量影响不大。
OBJECTIVES. The purpose of this work was to assess the effect of severe maternal iron-deficiency anemia and nutritional status on cord blood and breast milk iron status.METHODS. We conducted a prospective observational study over a 6-month period in a teaching hospital in central India. The study population consisted of 55 anemic (hemoglobin: < 110 g/L) and 20 healthy nonanemic (hemoglobin: < 110 g/L) pregnant women who delivered singleton live births at term gestation. We measured hemoglobin, iron, and ferritin levels in paired maternal and cord blood and iron levels in early (day 3 +/- 1) and late (day 15 +/- 3) transitional milk. Maternal anthropometry, including weight, height, midarm circumference, triceps skinfold thickness, and placental weight, were recorded. The main outcome measure of the study was to find out the relationship of maternal hemoglobin, iron, ferritin, and anthropometry with hemoglobin, iron, and ferritin in cord blood and iron levels in breast milk.RESULTS. Concentrations of hemoglobin, iron, and ferritin were significantly lower in the cord blood of anemic mothers and showed linear relationships with maternal hemoglobin and ferritin levels. Breast milk iron content was significantly reduced in severely anemic mothers but not in those with mild-to-moderate anemia. Breast milk iron level correlated with maternal hemoglobin and iron levels but not with ferritin levels. Maternal anthropometry had significant correlations with indices of iron nutriture in maternal and cord blood but showed no relationship with breast milk iron content. Placental weight was comparable between anemic and nonanemic mothers.CONCLUSIONS. Maternal anemia, particularly the severe type, adversely affects cord blood and breast milk iron status. Maternal nutritional status exerts a significant influence on fetal iron status but has little influence on breast milk iron content.