Anemia of Inflammation during Human Pregnancy Does Not Affect Newborn Iron Endowment
Anemia of Inflammation during Human Pregnancy Does Not Affect Newborn Iron Endowment
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DOI：
10.1093/jn/nxx052
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发表时间：
2018-03-01
影响因子：
4.2
通讯作者：
Friedman, Jennifer F.
中科院分区：
文献类型：
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作者：
Abioye, Ajibola I.;Park, Sangshin;Friedman, Jennifer F.
背景资料：据我们所知，目前还没有研究探讨母体炎症性贫血（AI）是否会影响新生儿的铁营养状况，也很少有研究探讨母体贫血特定病因的危险因素。本研究的目的是评估1）AI和缺铁性贫血（IDA）对新生儿铁营养的贡献，2）铁调素作为区分孕妇AI和IDA的生物标志物，和3）产妇贫血的特定病因的危险因素。方法：我们测量了血液学生物标志物在母体血液中的12和32周的妊娠和脐带血从吡喹酮在358例孕妇血吸虫在菲律宾的随机试验。IDA定义为血清铁蛋白< 30 ng/mL的贫血，而非IDA（NIDA），主要是由于AI，定义为铁蛋白>= 30 ng/mL的贫血。我们确定了截断的生物标志物，以区分IDA从NIDA通过使用曲线下面积（AUC）分析和检查不同原因的贫血对新生儿铁状态（主要结果）的影响，通过使用多元回归modeling.Results：在358位母亲，38%（n = 136）IDA和9%（n = 32）有NIDA在32周的妊娠。在妊娠32周时，血清铁调素比可溶性转铁蛋白受体（sTfR）在识别NIDA妇女与其余的队列（AUC：0.75和0.70，分别）和识别妇女与NIDA贫血妇女（0.73和0.72，分别）。在我们的队列中，最佳区分NIDA女性和IDA女性的临界值为6.1 μ g/L。母亲IDA，而不是NIDA，与显着降低新生儿铁蛋白（114.4 ng/mL相比，148.4 μ g/L; P = 0.042）。结论：铁调素在识别孕妇与NIDA，但其成本可能会限制其使用。母亲IDA，而不是NIDA，与新生儿铁储备减少有关，强调需要确定这一原因，并提供铁治疗。
Background: To our knowledge, no studies have addressed whether maternal anemia of inflammation (AI) affects newborn iron status, and few have addressed risk factors for specific etiologies of maternal anemia.Objectives: The study aims were to evaluate 1) the contribution of AI and iron deficiency anemia (IDA) to newborn iron endowment, 2) hepcidin as a biomarker to distinguish AI from IDA among pregnant women, and 3) risk factors for specific etiologies of maternal anemia.Methods: We measured hematologic biomarkers in maternal blood at 12 and 32 wk of gestation and in cord blood from a randomized trial of praziquantel in 358 pregnant women with Schistosoma japonicum in The Philippines. IDA was defined as anemia with serum ferritin < 30 ng/mL and non-IDA (NIDA), largely due to AI, as anemia with ferritin >= 30 ng/mL. We identified cutoffs for biomarkers to distinguish IDA from NIDA by using area under the curve (AUC) analyses and examined the impact of different causes of anemia on newborn iron status (primary outcome) by using multivariate regression modeling.Results: Of the 358 mothers, 38% (n = 136) had IDA and 9% (n = 32) had NIDA at 32 wk of gestation. At 32 wk of gestation, serum hepcidin performed better than soluble transferrin receptor (sTfR) in identifying women with NIDA compared with the rest of the cohort (AUCs: 0.75 and 0.70, respectively) and in identifying women with NIDA among women with anemia (0.73 and 0.72, respectively). The cutoff that optimally distinguished women with NIDA from women with IDA in our cohort was 6.1 mu g/L. Maternal IDA, but not NIDA, was associated with significantly lower newborn ferritin (114.4 ng/mL compared with 148.4 mu g/L; P = 0.042).Conclusions: Hepcidin performed better than sTfR in identifying pregnant women with NIDA, but its cost may limit its use. Maternal IDA, but not NIDA, is associated with decreased newborn iron stores, emphasizing the need to identify this cause and provide iron therapy.