Influence of maternal diabetes mellitus on fetal iron status.
OBJECTIVE
To determine the effects of maternal diabetes on fetal iron status using serum transferrin receptors (STfR) and their ratio to ferritin (TfR-F index) in cord blood.


METHODS
Iron, ferritin, erythropoietin, STfR and haemoglobin concentration were measured and TfR-F index calculated in 97 maternal/cord blood pairs. Forty-nine women had type 1 diabetes (diagnosed before pregnancy) and these were compared with forty-eight non- diabetic controls. The women with type 1 diabetes were recruited consecutively from attendance at the joint antenatal endocrine clinic while the control group of women was recruited from consecutive attendance at the remaining antenatal clinics.


RESULTS
The infants of the diabetic women had significantly lower levels of ferritin (47 vs 169 mug/l; p<0.01) and higher STfR (17.4 vs 12.9 mg/l; p<0.01) and TfR-F index (10.4 vs 5.8; p<0.01) than controls. They were also significantly more acidotic at birth (7.25 vs 7.30; p<0.01), were born at an earlier gestation (36.7 vs 39.7 weeks; p<0.01) and had higher z Scores for weight (0.53 vs 0.02; p = 0.016).


CONCLUSIONS
Maternal diabetes causes depletion of fetal iron stores and is associated with higher fetal iron demands as indicated by higher STfR level and TfR-F index in cord blood.
Verner
Alison Maria
AM
Regional Neonatal Unit, Royal Maternity Hospital, Grosvenor Road, Belfast BT12 6BB, Northern Ireland.
Manderson
John
J
Lappin
Terrence R J
TR
McCance
David R
DR
Halliday
Henry L
HL
Sweet
David G
DG
D001724:Birth Weight / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D004921:Erythropoietin / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D005312:Fetal Blood / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007501:Iron / Q000032:analysis*; D008431:Maternal-Fetal Exchange / Q000502:physiology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000378:metabolism*; D011990:Receptors, Transferrin / Q000097:blood
D011990:Receptors, Transferrin; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron