Frequency of Iron Deficiency among Neonates of Obese Females

Abstract

Background Obesity in pregnancy is a key risk factor for perinatal outcomes. It may result in maternal iron deficiency anaemia in later gestation, which could potentially cause decreased serum ferritin in neonates. This study aimed to determine the frequency of iron deficiency among neonates born to obese females. Material and Methods The study enrolled 200 obese mothers who were either primigravida or multigravida, aged between 18 and 42 years and had gestational age over 37 weeks. Only newborns with normal birth weight were included in the study, while twins, premature babies, babies having infections, and underweight and overweight babies were excluded. Maternal height and weight close to the delivery date were recorded, and body mass index was calculated. The study performed a complete blood count and serum ferritin of neonates on cord blood, which were then entered into a Performa. All results were analyzed using SPSS version 20. Results The mean age of the study population (mothers) was 31.64 + 5.42 years, ranging from 18 to 42 years. The mean body mass index was 36.4 + 3.05 kg/m2. The prevalence of anaemia among newborns was found to be 27%. The study found that among women in the severe obesity category, 10 (34.5%) newborns were anaemic, while in women with moderate obesity, 26 (26%) newborns had anaemia. Additionally, among women with mild obesity, 18 (25.4%) newborns were anaemic (p = 0.615). Conclusions The study findings thus showed a higher prevalence of anaemia in newborns of severely obese mothers compared to moderate and mild levels of obesity, though the results were clinically insignificant.

Keywords

• Iron deficiency
• Neonates
• Obesity

References

1. Guelinckx I, Devlieger R, Beckers K, Vansant G. Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obes Rev. 2008 Mar;9(2):140-50. doi: 10.1111/j.1467-789X.2007.00464.x.
2. Syed W. Obesity related maternal complications in pregnant women. Khyber Med Univ J. 2014 July-Sep;6(3):128-30.
3. Yanoff LB, Menzie CM, Denkinger B, Sebring NG, McHugh T, Remaley AT, Yanovski JA. Inflammation and iron deficiency in the hypoferremia of obesity. Int J Obes (Lond). 2007 Sep;31(9):1412-9. doi: 10.1038/sj.ijo.0803625.
4. Bradley J, Leibold EA, Harris ZL, Wobken JD, Clarke S, Zumbrennen KB, Eisenstein RS, Georgieff MK. Influence of gestational age and fetal iron status on IRP activity and iron transporter protein expression in third-trimester human placenta. Am J Physiol Regul Integr Comp Physiol. 2004 Oct;287(4):R894-901. doi: 10.1152/ajpregu.00525.2003.
5. Phillips AK, Roy SC, Lundberg R, Guilbert TW, Auger AP, Blohowiak SE, Coe CL, Kling PJ. Neonatal iron status is impaired by maternal obesity and excessive weight gain during pregnancy. J Perinatol. 2014 Jul;34(7):513-8. doi: 10.1038/jp.2014.42.
6. O'Brien KO, Zavaleta N, Abrams SA, Caulfield LE. Maternal iron status influences iron transfer to the fetus during the third trimester of pregnancy. Am J Clin Nutr. 2003 Apr;77(4):924-30. doi: 10.1093/ajcn/77.4.924.
7. McClung JP, Karl JP. Iron deficiency and obesity: the contribution of inflammation and diminished iron absorption. Nutr Rev. 2009 Feb;67(2):100-4. doi: 10.1111/j.1753-4887.2008.00145.x.
8. Tussing-Humphreys L, Pusatcioglu C, Nemeth E, Braunschweig C. Rethinking iron regulation and assessment in iron deficiency, anemia of chronic disease, and obesity: introducing hepcidin. J Acad Nutr Diet. 2012 Mar;112(3):391-400. doi: 10.1016/j.jada.2011.08.038.

9. Lozoff B, Beard J, Connor J, Barbara F, Georgieff M, Schallert T. Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev. 2006 May;64(5 Pt 2):S34-43; discussion S72-91. doi: 10.1301/nr.2006.may.s34-s43.
10. Dao MC, Sen S, Iyer C, Klebenov D, Meydani SN. Obesity during pregnancy and fetal iron status: is Hepcidin the link? J Perinatol. 2013 Mar;33(3):177-81. doi: 10.1038/jp.2012.81.
11. Iron nutrition during pregnancy. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Washington (DC): National Academies Press (US); 1990.
12. Flores-Quijano ME, Vega-Sánchez R, Tolentino-Dolores MC, López-Alarcón MG, Flores-Urrutia MC, López-Olvera AD, Talavera JO. Obesity is associated with changes in iron nutrition status and its homeostatic regulation in pregnancy. Nutrients. 2019 Mar 23;11(3):693. doi: 10.3390/nu11030693.
13. Siddiqui M, Ayub H, Hameed R, Nadeem MI, Mohammad TA, Simbak N, Latif AZA, Abubakar Y, Baig AA. Obesity in Pakistan; Current and future perceptions. Curr Trends Biomedical Eng Biosci. 2018 Nov;17(2):555958. doi: 10.19080/CTBEB.2018.17.555958.
14. Ali HS, Lakhani N. Effect of obesity and its outcome among pregnant women. Pak J Med Sci. 2011 Oct-Dec;27(5):1126-8.
15. Pakistan 2012-13 Demographic and Health Survey Key Findings. National Institute of Population Studies [Pakistan] and ICF International. 2013. Calverton, Maryland, USA: National Institute of Statistics and ICF International. 2013:1-20. Avaliable at: https://dhsprogram.com/pubs/pdf/SR208/SR208.pdf. Accessed Dec 10, 2022.
16. Balarajan Y, Villamor E. Nationally representative surveys show recent increases in the prevalence of overweight and obesity among women of reproductive age in Bangladesh, Nepal, and India. J Nutr. 2009 Nov;139(11):2139-44. doi: 10.3945/jn.109.112029.
17. Najmi RS. Distribution of birthweights of hospital born Pakistani infants. J Pak Med Assoc. 2000 Apr;50(4):121-4.
18. Villamor E, Msamanga G, Urassa W, Petraro P, Spiegelman D, Hunter DJ, Fawzi WW. Trends in obesity, underweight, and wasting among women attending prenatal clinics in urban Tanzania, 1995-2004. Am J Clin Nutr. 2006 Jun;83(6):1387-94. doi: 10.1093/ajcn/83.6.1387.
19. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014 Aug 30;384(9945):766-81. doi: 10.1016/S0140-6736(14)60460-8.