title: Impact of maternal, antenatal and birth-associated factors on iron stores at birth: data from a prospective maternal-infant birth cohort.
abstract: Low serum ferritin concentrations at birth, which reflect neonatal iron stores, track through to early childhood and have been associated with poorer neurodevelopmental outcomes. We aimed to identify maternal, antenatal and birth-associated factors that influence iron stores at birth in a prospective maternal-infant birth cohort.
  
  
  
  In a population-based, longitudinal, birth cohort in Ireland, 413 maternal-infant dyads with prospectively collected lifestyle and clinical data from 15 weeks' gestation had umbilical cord serum ferritin concentrations measured. Regression models were developed to identify independent factors associated with cord ferritin concentrations.
  
  
  
  Median (IQR) cord ferritin concentrations were 185.7 (131.7, 385.5) μg/l, and 8% (n=33) of infants had low iron stores (ferritin <76 μg/l) at birth. Maternal obesity (BMI ⩾30 kg/m2) at 15 weeks' gestation (adj. estimate (95% confidence interval (CI)): -66.4 (-106.9, -25.9) μg/l, P<0.0001) and delivery by caesarean section (-38.8 (-70.2, -7.4) μg/l, P=0.016) were inversely associated with cord ferritin concentrations. In addition, maternal smoking at 15 weeks' gestation (adj. odds ratio (95% CI): 2.9 (1.2, 7), P=0.020) and being born small-for-gestational age (3.4 (1.3, 8.9), P=0.012) were associated with an increased risk of low iron stores (ferritin <76 μg/l) at birth.
  
  
  
  We have identified a number of potentially modifiable lifestyle factors that influence iron stores at birth, with the important role of overall maternal health and lifestyle during pregnancy highlighted. Public health policies targeting women of child-bearing age to improve nutrition and health outcomes should be prioritised for the health of the next generation.
authors.affiliation: Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland.|The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Republic of Ireland.
authors.forename: E K
authors.initials: EK
authors.lastname: McCarthy
authors.affiliation: The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Republic of Ireland.|Department of Obstetrics and Gynaecology, University College Cork, Cork, Republic of Ireland.
authors.forename: L C
authors.initials: LC
authors.lastname: Kenny
authors.affiliation: The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Republic of Ireland.|Department of Paediatrics and Child Health, University College Cork, Cork, Republic of Ireland.
authors.forename: J O B
authors.initials: JOB
authors.lastname: Hourihane
authors.affiliation: Department of Clinical Medicine, Trinity College, Dublin, Republic of Ireland.|Department of Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Republic of Ireland.|National Children's Research Centre, Dublin, Republic of Ireland.
authors.forename: A D
authors.initials: AD
authors.lastname: Irvine
authors.affiliation: The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Republic of Ireland.|Department of Paediatrics and Child Health, University College Cork, Cork, Republic of Ireland.
authors.forename: D M
authors.initials: DM
authors.lastname: Murray
authors.affiliation: Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland.|The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Republic of Ireland.
authors.forename: M E
authors.initials: ME
authors.lastname: Kiely
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control; D015992:Body Mass Index; D005260:Female; D005293:Ferritins / Q000097:blood; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood; D007494:Ireland; D007501:Iron / Q000097:blood*; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D011247:Pregnancy; D047928:Premature Birth / Q000097:blood; D011295:Prenatal Care; D011446:Prospective Studies; D012959:Socioeconomic Factors
chemical_list: D005293:Ferritins; D007501:Iron