29 April 2012

Maternal Stress Puts Newborns At Risk For Iron Deficiency Anemia

When red blood cells fail to bring sufficient amounts of oxygen to the tissues in the body, the person becomes anemic. There are different factors that can cause anemia but iron deficiency is the most common cause.

The body requires iron to make hemoglobin. This is the oxygen carrying red pigment in blood. If there isn't enough iron in the body, the production of hemoglobin becomes limited. This in turn affects the production of red blood cells (RBC). A decreased amount of hemoglobin and RBCs in the bloodstream resulting in less oxygen available to cells and tissues is known as anemia. Without the right amount of oxygen, these cells and tissues does not function well.

Iron deficiency anemia (IDA) is primarily caused by insufficient iron intake. This is the major factor of childhood anemia. It has become much less common in the United States over the past 30 years, primarily due to iron-fortified infant formulas and cereals but is a concern in third world and developing countries.

Iron-deficiency anemia doesn't develop immediately. Instead, a person progresses through stages of iron deficiency, beginning with iron depletion, in which the amount of iron in the body is reduced while the iron in RBCs remains constant. If iron depletion isn't corrected, it progresses to iron deficiency, eventually leading to IDA.

Mom's stress during pregnancy can affect baby's iron status

Newborns whose mothers are under stress during the first trimester of pregnancy may be at risk for low iron status, which could lead to physical and mental delays down the road, according to a study to be presented Sunday, April 29, at the Pediatric Academic Societies (PAS) annual meeting in Boston.

Iron plays an important role in the development of organ systems, especially the brain. Well-known risk factors for poor iron status in infants are maternal iron deficiency, maternal diabetes, smoking during pregnancy, preterm birth, low birthweight and multiple pregnancy.

This study, conducted by researchers from Ashkelon Academic College and Barzilai Medical Center in Israel and the University of Michigan, is the first in humans to suggest that maternal stress early in pregnancy is another risk factor for low iron status in newborns.

Video: Iron Deficiency Anemia in Infants

Researchers, led by Rinat Armony-Sivan, PhD, director of the psychology research laboratory at Ashkelon Academic College, recruited pregnant women who were about to give birth at Barzilai Medical Center. The first group of women (stress group) lived in an area where there were more than 600 rocket attacks ("Oferet Yetzuka" operation) during their first trimester of pregnancy. The control group lived in the same area and became pregnant three to four months after the rocket attacks ended.

Women were questioned briefly at the delivery room reception desk to determine whether they were healthy and without pregnancy complications. Eligible women who agreed to participate in the study were interviewed one or two days after delivery about their background and health during pregnancy. They also filled out questionnaires about depression and anxiety, and rated their stress level during pregnancy.

Cord blood was collected from newborns, and serum ferritin (iron) concentrations were measured.

Results showed that the 63 babies whose mothers were in the stress group had significantly lower cord-blood ferritin concentrations than the 77 infants in the control group.

"Our findings indicate that infants whose mothers were stressed during pregnancy are a previously unrecognized risk group for iron deficiency," Dr. Armony-Sivan said. "Pregnant women should be aware that their health, nutrition, stress level and state of mind will affect their baby's health and well-being."

Dr. Armony-Sivan concluded that it may be advisable to consider additional blood work before the well-child visit at 12 months of age, especially in high-risk populations, so that iron deficiency, with or without anemia, can be detected early and treated before it becomes chronic and severe.


American Academy of Pediatrics
Pediatric Academic Societies
Ashkelon Academic College
Barzilai Medical Center
University of Michigan
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