Association of increased maternal ferritin levels with gestational diabetes and intra-uterine growth retardation.
ABSTRACT The objectives of the present study were to determine whether or not increased serum ferritin in women with premature labour is associated with gestational diabetes mellitus (GDM) and intra-uterine growth retardation (IUGR) and, if so, whether or not such increased levels reflect excess maternal iron stores, and have an effect on neonatal iron status and outcome.
This prospective, single-hospital, observational study involved 63 mothers and their 90 preterm neonates. Full blood counts as well as serum ferritin, soluble transferrin receptor (sTfR) and erythropoietin concentrations were compared across the three study groups based on maternal ferritin levels at the time of delivery. Perinatal history, neonatal morbidity and early outcomes were also assessed.
High maternal ferritin levels were significantly associated with higher rates of GDM and IUGR. However, there was no correlation between maternal ferritin and sTfR levels or between maternal and neonatal iron status.
Elevated maternal ferritin is not a reflection of excess iron stores, but is related to an increased risk of GDM or IUGR. Also, maternal ferritin levels are not associated with either neonatal iron status or neonatal outcomes.
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ABSTRACT: Background:Fetal growth restriction is reported to be associated with impaired placental iron transport. Transferrin receptor (TfR) is a major placental iron transporter in humans, but is unstudied in sheep. TfR is regulated by both iron and nitric oxide (NO), the molecule produced by endothelial NOS (eNOS). We hypothesized that limited placental development downregulates both placental TfR and eNOS expression, thereby lowering fetal tissue iron.Methods:An ovine surgical uterine space restriction (USR) model, combined with multifetal gestation, tested the extremes of uterine and placental adaptation. Blood, tissues, and placentomes from non-space restricted (NSR) singletons were compared to USR fetuses at 120 or 130 days of gestation (GD).Results:When expressed proportionate to fetal weight, liver iron content did not differ while renal iron was higher in USR vs. NSR fetuses. Renal TfR protein expression did not differ, but placental TfR expression was lower in USR fetuses at GD130. Placental levels of TfR correlated to eNOS. TfR was localized throughout the placentome, including the hemophagous zone, implicating a role for TfR in ovine placental iron transport.Conclusion:In conclusion, fetal iron was regulated in an organ-specific fashion. In USR fetuses, NO-mediated placental adaptations may prevent the normal upregulation of placental TfR at GD130.Pediatric Research (2012); doi:10.1038/pr.2012.180.Pediatric Research 11/2012; · 2.67 Impact Factor
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ABSTRACT: Objective: To examine the potential value of maternal serum level of ferritin in the first trimester of pregnancy in the prediction of spontaneous early preterm delivery. Methods: Maternal serum concentration of ferritin at 11-13-week gestation was measured in a case-control study of singleton pregnancies delivering phenotypically normal neonates, including 30 cases with spontaneous delivery before 34 weeks and 90 matched controls delivering after 37 weeks. The median multiple of the median (MoM) serum ferritin in the two outcome groups was compared. Results: The median serum ferritin MoM was not significantly different in the spontaneous early preterm delivery group compared with the term delivery group (1.143, interquartile range [IQR] 0.578-2.383 vs. 1.059, IQR 0.641-1.644, p = 0.725). Conclusions: Measurement of maternal serum ferritin at 11-13 weeks is unlikely to be useful in screening for spontaneous early preterm delivery.The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 04/2012; 25(10):1852-5. · 1.36 Impact Factor
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ABSTRACT: Our purpose was to evaluate the predictive value of maternal serum and amniotic fluid biomarkers that were obtained at the time of genetic amniocentesis for preterm delivery and intrauterine growth retardation (IUGR).Journal of Obstetrics and Gynaecology Research 06/2014; 40(6):1540-6. · 0.84 Impact Factor