Cord blood and breast milk iron status in maternal anemia.
OBJECTIVE
The purpose of this work was to assess the effect of severe maternal iron-deficiency anemia and nutritional status on cord blood and breast milk iron status.


METHODS
We conducted a prospective observational study over a 6-month period in a teaching hospital in central India. The study population consisted of 55 anemic (hemoglobin: < 110 g/L) and 20 healthy nonanemic (hemoglobin: > or = 110 g/L) pregnant women who delivered singleton live births at term gestation. We measured hemoglobin, iron, and ferritin levels in paired maternal and cord blood and iron levels in early (day 3 +/- 1) and late (day 15 +/- 3) transitional milk. Maternal anthropometry, including weight, height, midarm circumference, triceps skinfold thickness, and placental weight, were recorded. The main outcome measure of the study was to find out the relationship of maternal hemoglobin, iron, ferritin, and anthropometry with hemoglobin, iron, and ferritin in cord blood and iron levels in breast milk.


RESULTS
Concentrations of hemoglobin, iron, and ferritin were significantly lower in the cord blood of anemic mothers and showed linear relationships with maternal hemoglobin and ferritin levels. Breast milk iron content was significantly reduced in severely anemic mothers but not in those with mild-to-moderate anemia. Breast milk iron level correlated with maternal hemoglobin and iron levels but not with ferritin levels. Maternal anthropometry had significant correlations with indices of iron nutriture in maternal and cord blood but showed no relationship with breast milk iron content. Placental weight was comparable between anemic and nonanemic mothers.


CONCLUSIONS
Maternal anemia, particularly the severe type, adversely affects cord blood and breast milk iron status. Maternal nutritional status exerts a significant influence on fetal iron status but has little influence on breast milk iron content.
Kumar
Ashok
A
Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India. ashokkumar_bhu@hotmail.com
Rai
Arun Kumar
AK
Basu
Sriparna
S
Dash
Debabrata
D
Singh
Jamuna Saran
JS
D000328:Adult; D000704:Analysis of Variance; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007501:Iron / Q000032:analysis*; D008895:Milk, Human / Q000737:chemistry*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000453:epidemiology; D011256:Pregnancy Outcome; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D018709:Statistics, Nonparametric
D006454:Hemoglobins; D007501:Iron