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Published Online First: 9 November 2006. doi:10.1136/adc.2006.097279
Archives of Disease in Childhood - Fetal and Neonatal Edition 2007;92:F399-F401
Copyright © 2007 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

ORIGINAL ARTICLE

Influence of maternal diabetes mellitus on fetal iron status

Alison Maria Verner, John Manderson, Terrence R J Lappin, David R McCance, Henry L Halliday and David G Sweet

Departments of Child Health and Haematology, Queen’s University Belfast, Regional Neonatal Unit, Royal Maternity Hospital, Belfast, and Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, Northern Ireland

Correspondence to:
Dr D G Sweet, Regional Neonatal Unit, Royal Maternity Hospital, Grosvenor Road, Belfast BT12 6BB, Northern Ireland; david.sweet{at}belfasttrust.hscni.net

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 µg/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.


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