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Overweight and obesity causes low-grade systemic inflammation, which sharply increases risk for iron deficiency. Studies in our laboratory have shown that this is mainly the result of reduced dietary iron absorption because of increased hepcidin concentrations. During pregnancy, women have a large increase in iron needs because of the expansion of maternal blood volume and fetal needs. Iron deficiency anemia in infancy can impair cognitive development. Whether maternal adiposity impairs absorption and transfer of iron to the fetus, and thereby increases risk of iron deficiency in the mother and the infant is unclear.
In obese subjects, hepcidin concentrations are increased and iron absorption is believed to be reduced, leading to iron deficiency over time. How all this will influence iron supply of the fetus in obese pregnancy has not been well investigated to date. Even if maternal and fetal iron uptakes are regulated separately, it is unclear to what extent maternal subclinical inflammation might influence this process. A small study by Dao et al. indicated that maternal-fetal iron transfer was impaired in obese pregnant women, possibly due to hepcidin up-regulation. In this study, both maternal BMI as well as hepcidin were negatively correlated with cord blood iron status. Maternal hepcidin and c-reactive protein were significantly higher and cord blood iron was significantly lower in the obese compared to the normal weight. Hepcidin was shown to have an effect on iron transfer across the placenta in the study by Young et al.: the transfer was increased in women with undetectable hepcidin at delivery compared to those with higher levels. As of now, clear associations between maternal BMI or maternal hepcidin concentration and fetal iron status were not shown.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Isotopically labeled test meal week of pregnancy 20 | Experimental |
| |
| Isotopically labeled test meal week of pregnancy 30 | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stable iron isotope 57 (57Fe) labeled iron solution | Other | test meal labeled with 12 mg 57Fe |
|
| Measure | Description | Time Frame |
|---|---|---|
| Fractional iron absorption | The fractional iron absorption from the first test meal will be calculated based on the shift of the iron isotopic ratios in the collected blood samples 14 days after administration of the isotopically labeled meal. | week 20 of pregnancy |
| iron transfer from the mother to the fetus in cord blood/infant | To determine the amount of iron transferred from the mother to the fetus | delivery |
| Fractional iron absorption | The fractional iron absorption from the second test meal will be calculated based on the shift of the iron isotopic ratios in the collected blood samples 14 days after administration of the isotopically labeled meal. | week 30 of pregnancy |
| infants iron status | infants iron status | over the first six months of life |
| Measure | Description | Time Frame |
|---|---|---|
| Change in plasma ferritin | Change in plasma ferritin | weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Change in Hepcidin | Change in Hepcidin |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Human Nutrition Laboratory ETH Zurich | Zurich | 8092 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34910118 | Derived | Stoffel NU, Zimmermann MB, Cepeda-Lopez AC, Cervantes-Gracia K, Llanas-Cornejo D, Zeder C, Tuntipopipat S, Moungmaithong S, Densupsoontorn N, Quack Loetscher K, Gowachirapant S, Herter-Aeberli I. Maternal iron kinetics and maternal-fetal iron transfer in normal-weight and overweight pregnancy. Am J Clin Nutr. 2022 Apr 1;115(4):1166-1179. doi: 10.1093/ajcn/nqab406. |
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| Stable iron isotope 58 (58Fe) labeled iron solution | Other | test meal labeled with 12 mg 58Fe |
|
| weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Change in transferrin receptor | Change in transferrin receptor | weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Change in hemoglobin | Change in hemoglobin | weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Change in c-reactive protein | Change in c-reactive protein | weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Change in interleukin-6 | Change in interleukin-6 | weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Chage in alpha-1-acid glycoprotein | Chage in alpha-1-acid glycoprotein | weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Change in retinol binding protein | Change in retinol binding protein | weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Change in riboflavin | Change in riboflavin | weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery |
| Assessment of children's iron needs within their first 2 years of life using an isotope dilution technique | Assessment of children's iron needs within their first 2 years of life | Follow-up blood samples at 3, 6, 12, 18, 24 months after birth |
| Assessment of recovery of mother's iron Status after pregnancy using an isotope dilution technique | Assessment of recovery of mother's iron Status after pregnancy | Follow-up blood samples at 3, 6, 12, 18, 24 months after delivery |
| infants iron status | infants iron status | over the first 24 months of life |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D009765 | Obesity |
| ID | Term |
|---|---|
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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