Correlates of Maternal Iron Stores During Pregnancy and Cord Blood Ferritin Levels at Delivery in a Nigerian Tertiary Hospital.

BACKGROUND

Insufficient iron is a common nutritional deficiency globally. It is a significant cause of anemia in pregnancy and a common problem in obstetric care due to the increased demand for iron by the developing fetus and placenta. It has been associated with adverse maternal and perinatal outcomes. To maintain iron balance, maternal iron stores before and during pregnancy have been suggested to be an indispensable factor. However, there is no consensus on the effect of iron stores in mothers on neonatal iron stores.

AIM: To establish the relationship between maternal iron stores in pregnancy and cord ferritin at delivery, birth weight, placenta weight, and Apgar scores.

METHODOLOGY: This study included 170 mothers and neonatal pairs. Maternal venous blood was obtained in labor, while 5 ml of cord blood was collected soon after childbirth for ferritin and hemoglobin assay using enzyme-linked immunosorbent assay (ELISA) and a hemoglobinometer, respectively. Sociodemographic details, birth weight, placenta weight, and Apgar scores were obtained. IBM SPSS version 22 (IBM Corp., Armonk, NY) was employed to carry out the statistical data analysis.

RESULT: The prevalence of iron deficiency was 27.6% (47). The mean maternal ferritin concentration was 23.9 ± 19.8 ng/ml. The mean cord ferritin was 223 ± 234 ng/ml. There was no relationship between maternal ferritin levels and cord ferritin (r = 0.002, p = 0.981), cord hemoglobin, placenta weight, birth weight, and Apgar score. Cord ferritin and cord hemoglobin showed a negative correlation (r = -0.222, P = 0.004). The mean hemoglobin level (14.3 ± 1.9) was significantly higher in neonates with lower ferritin (t = 2.960, p = 0.004). Apgar scores at one and five minutes were significantly lower in neonates with low cord blood ferritin compared to neonates having normal blood ferritin (at one minute: 7 ± 1 vs. 8 ± 1, p = 0.039; at five minutes: 9 ± 1 vs. 10 ± 1, p = 0.011).

CONCLUSION

Maternal iron stores and neonatal iron stores showed no relationship between them at delivery. The inverse relationship between cord ferritin and neonatal hemoglobin suggests that some unexplained factors may be responsible for this, which warrants further research. Furthermore, adequate iron stores influenced better neonatal outcomes.