title: Effect of Severe Maternal Iron Deficiency Anemia on Neonatal Platelet Indices.
abstract: OBJECTIVE
  To evaluate the effect of maternal iron deficiency anemia (IDA) on fetal thrombopoiesis.
  
  
  METHODS
  In this prospective observational study, maternal and cord blood iron status parameters (serum iron, serum ferritin, total iron-binding capacity, and transferrin saturation), and platelet indices, such as, absolute platelet count (APC), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit, were estimated in a convenient sample of 142 mothers with IDA (hemoglobin <11 g/dl and serum ferritin <12 ng/ml) and an equal number of healthy non-anemic (hemoglobin ≥11 g/dl) mothers, who delivered singleton live neonates at term gestation. Mothers with antenatal thrombocytopenia, infections, inflammatory conditions, pregnancy-induced hypertension and neonates with perinatal asphyxia, sepsis and congenital malformations were excluded.
  
  
  RESULTS
  For statistical analysis, the IDA group was further subdivided into mild-to-moderate (hemoglobin 7-10.9 g/dl) and severe (hemoglobin <7 g/dl) anemia. Cord blood APC and PDW were comparable between non-anemic and mild-to-moderate anemic mothers (242,550 ± 54,320/μL vs. 235,260 ± 34,620/μL for APC and 16.2 ± 1.4 vs. 16.4 ± 1.8 fl for PDW, respectively), but in severe IDA group, cord blood APC and PDW were significantly lower (74,520 ± 12,380/μL and 17.8 ± 2.1 fl, respectively, p < 0.001). MPV and plateletcrit were comparable. None of the study neonates had a platelet count <30,000/μL or showed any evidence of clinical bleeding.
  
  
  CONCLUSIONS
  Neonates born to mothers with severe IDA had moderate thrombocytopenia with increased PDW, though no change was observed in MPV and plateletcrit. Further studies should be carried out to identify the cause and consequences of this observation.
authors.affiliation: The Neonatal Unit, Department of Pediatrics, Institure of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India. drsriparnabasu@rediffmail.com.
authors.forename: Sriparna
authors.initials: S
authors.lastname: Basu
authors.affiliation: The Neonatal Unit, Department of Pediatrics, Institure of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Biochemistry, Institure of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Ragini
authors.initials: R
authors.lastname: Srivastava
authors.affiliation: The Neonatal Unit, Department of Pediatrics, Institure of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D004909:Erythrocyte Indices; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D063847:Mean Platelet Volume / Q000379:methods*; D010976:Platelet Count / Q000379:methods*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013921:Thrombocytopenia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology
chemical_list: D006454:Hemoglobins
keywords: Absolute platelet count; Iron deficiency anemia; Maternal; Mean platelet volume; Neonatal; Platelet distribution width