Skip to main content
×
×
Home

Maternal iron intake during pregnancy and birth outcomes: a cross-sectional study in Northwest China

  • Jiaomei Yang (a1), Yue Cheng (a2), Leilei Pei (a1), Yufen Jiang (a1) (a3), Fangliang Lei (a1), Lingxia Zeng (a1), Quanli Wang (a1), Qiang Li (a1), Yijun Kang (a1), Yuan Shen (a1), Shaonong Dang (a1) and Hong Yan (a1) (a4)...
Abstract

Previous studies have yielded conflicting results on the associations of maternal Fe intake with birth outcomes. This study aimed to investigate the associations between maternal Fe intake (total Fe from diet and supplements, dietary total Fe, haeme Fe, non-haeme Fe and Fe supplements use) and adverse birth outcomes in Shaanxi Province of Northwest China. In all, 7375 women were recruited using a stratified multistage random sampling method at 0–12 months (median 3; 10th–90th percentile 0–7) after delivery. Diets were collected by a validated FFQ and maternal characteristics were obtained via a standard questionnaire. The highest tertile of haeme Fe intake compared with the lowest tertile was negatively associated with low birth weight (LBW) (OR 0·68; 95 % CI 0·49, 0·94), small for gestational age (SGA) (OR 0·76; 95 % CI 0·62, 0·94) and birth defects (OR 0·55; 95 % CI 0·32, 0·89). Maternal haeme Fe intake was associated with a lower risk of intra-uterine growth retardation (IUGR) (medium tertile v. lowest tertile: OR 0·78; 95 % CI 0·61, 0·95; highest tertile v. lowest tertile: OR 0·76; 95 % CI 0·59, 0·93; P trend=0·045). The OR of LBW associated with Fe supplements use were as follows: during pregnancy: 0·72 (95 % CI 0·50, 0·95); in the second trimester: 0·67 (95 % CI 0·42, 0·98); in the third trimester: 0·47 (95 % CI 0·24, 0·93). We observed no associations of total Fe, dietary total Fe or non-haeme Fe intake with birth outcomes. The results suggest that maternal haeme Fe intake is associated with a reduced risk of LBW, SGA, IUGR and birth defects, and Fe supplements use during pregnancy reduces LBW risk.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Maternal iron intake during pregnancy and birth outcomes: a cross-sectional study in Northwest China
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Maternal iron intake during pregnancy and birth outcomes: a cross-sectional study in Northwest China
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Maternal iron intake during pregnancy and birth outcomes: a cross-sectional study in Northwest China
      Available formats
      ×
Copyright
Corresponding author
* Corresponding authors: H. Yan, fax +86 29 82655104, email xjtu_yh2014@163.com; S. Dang, fax +86 29 82655104, email tjdshn@mail.xjtu.edu.cn
References
Hide All
1. Lopez, A, Cacoub, P, Macdougall, IC, et al. (2016) Iron deficiency anaemia. Lancet 387, 907916.
2. Haider, BA, Olofin, I, Wang, M, et al. (2013) Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ 346, f3443.
3. Zeng, L, Dibley, MJ, Cheng, Y, et al. (2008) Impact of micronutrient supplementation during pregnancy on birth weight, duration of gestation, and perinatal mortality in rural western China: double blind cluster randomised controlled trial. BMJ 337, a2001.
4. Christian, P, Murray-Kolb, LE, Khatry, SK, et al. (2010) Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal. JAMA 304, 27162723.
5. Peña-Rosas, JP, De-Regil, LM, Garcia-Casal, MN, et al. (2015) Daily oral iron supplementation during pregnancy. The Cochrane Database Systematic Reviews 2015, issue 7, CD004736.
6. Li, C, Zeng, L, Wang, D, et al. (2015) Prenatal micronutrient supplementation is not associated with intellectual development of young school-aged children. J Nutr 145, 18441849.
7. Andersen, HS, Gambling, L, Holtrop, G, et al. (2006) Maternal iron deficiency identifies critical windows for growth and cardiovascular development in the rat postimplantation embryo. J Nutr 136, 11711177.
8. Gambling, L, Dunford, S, Wallace, DI, et al. (2003) Iron deficiency during pregnancy affects postnatal blood pressure in the rat. J Physiol 552, 603610.
9. Hurrell, R & Egli, I (2010) Iron bioavailability and dietary reference values. Am J Clin Nutr 91, 1461s1467s.
10. Khambalia, AZ, Aimone, A, Nagubandi, P, et al. (2015) High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review. Diabet Med 33, 12111221.
11. Bao, W, Rong, Y, Rong, S, et al. (2012) Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis. BMC Med 10, 119.
12. Lee, SE, Talegawkar, SA, Merialdi, M, et al. (2013) Dietary intakes of women during pregnancy in low- and middle-income countries. Public Health Nutr 16, 13401353.
13. Mathews, F, Yudkin, P & Neil, A (1999) Influence of maternal nutrition on outcome of pregnancy: prospective cohort study. BMJ 319, 339343.
14. Lagiou, P, Mucci, L, Tamimi, R, et al. (2005) Micronutrient intake during pregnancy in relation to birth size. Eur J Nutr 44, 5259.
15. Baker, PN, Wheeler, SJ, Sanders, TA, et al. (2009) A prospective study of micronutrient status in adolescent pregnancy. Am J Clin Nutr 89, 11141124.
16. Alwan, NA, Greenwood, DC, Simpson, NA, et al. (2011) Dietary iron intake during early pregnancy and birth outcomes in a cohort of British women. Hum Reprod 26, 911919.
17. Groenen, PM, van Rooij, IA, Peer, PG, et al. (2004) Low maternal dietary intakes of iron, magnesium, and niacin are associated with spina bifida in the offspring. J Nutr 134, 15161522.
18. Shaw, GM, Carmichael, SL, Yang, W, et al. (2010) Periconceptional nutrient intakes and risks of conotruncal heart defects. Birth Defects Res A Clin Mol Teratol 88, 144151.
19. Zhai, FY, Du, SF, Wang, ZH, et al. (2014) Dynamics of the Chinese diet and the role of urbanicity, 1991–2011. Obes Rev 15, Suppl. 1, 1626.
20. Yang, J, Dang, S, Cheng, Y, et al. (2017) Dietary intakes and dietary patterns among pregnant women in Northwest China. Public Health Nutr 20, 282293.
21. Crozier, SR, Robinson, SM, Godfrey, KM, et al. (2009) Women’s dietary patterns change little from before to during pregnancy. J Nutr 139, 19561963.
22. Rifas-Shiman, SL, Rich-Edwards, JW, Willett, WC, et al. (2006) Changes in dietary intake from the first to the second trimester of pregnancy. Paediatr Perinat Epidemiol 20, 3542.
23. Cheng, Y, Yan, H, Dibley, MJ, et al. (2008) Validity and reproducibility of a semi-quantitative food frequency questionnaire for use among pregnant women in rural China. Asia Pac J Clin Nutr 17, 166177.
24. Institute of Nutrition and Food Safety & China Center for Disease Control and Prevention (2009) China Food Composition Book 1, 2nd ed. Beijing: Peking University Medical Press.
25. Institute of Nutrition and Food Safety & China Center for Disease Control and Prevention (2005) China Food Composition Book, 2nd ed. Beijing: Peking University Medical Press.
26. Chinese Nutrition Society (2014) Chinese Dietary Reference Intakes 2013. Beijing: Science Press.
27. Zhu, L, Zhang, R, Zhang, S, et al. (2015) Chinese neonatal birth weight curve for different gestational age. Zhonghua Er Ke Za Zhi 53, 97103.
28. Willett, W (2013) Nutritional Epidemiology, 3rd ed. New York: Oxford University Press.
29. Filmer, D & Pritchett, LH (2001) Estimating wealth effects without expenditure data – or tears: an application to educational enrollments in states of India. Demography 38, 115132.
30. Schulze, MB, Hoffmann, K, Kroke, A, et al. (2003) An approach to construct simplified measures of dietary patterns from exploratory factor analysis. Br J Nutr 89, 409419.
31. Yang, J, Qiu, H, Qu, P, et al. (2015) Prenatal alcohol exposure and congenital heart defects: a meta-analysis. PLOS ONE 10, e0130681.
32. Cook, JD (1990) Adaptation in iron metabolism. Am J Clin Nutr 51, 301308.
33. Rahman, MM, Abe, SK, Rahman, MS, et al. (2016) Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr 103, 495504.
34. Alwan, NA, Cade, JE, McArdle, HJ, et al. (2015) Maternal iron status in early pregnancy and birth outcomes: insights from the Baby’s Vascular health and Iron in Pregnancy study. Br J Nutr 113, 19851992.
35. Young, MF, Griffin, I, Pressman, E, et al. (2012) Maternal hepcidin is associated with placental transfer of iron derived from dietary heme and nonheme sources. J Nutr 142, 3339.
36. Simavli, S, Derbent, AU, Keskin, EA, et al. (2015) Do the first, second and third trimester maternal serum hepcidin concentrations clarify obstetric complications? J Matern Fetal Neonatal Med 28, 854857.
37. Hur, J, Kim, H, Ha, EH, et al. (2013) Birth weight of Korean infants is affected by the interaction of maternal iron intake and GSTM1 polymorphism. J Nutr 143, 6773.
38. Bunin, GR, Gyllstrom, ME, Brown, JE, et al. (2001) Recall of diet during a past pregnancy. Am J Epidemiol 154, 11361142.
39. Bosco, JL, Tseng, M, Spector, LG, et al. (2010) Reproducibility of reported nutrient intake and supplement use during a past pregnancy: a report from the Children’s Oncology Group. Paediatr Perinat Epidemiol 24, 93101.
40. Kvalvik, LG, Nilsen, RM, Skjaerven, R, et al. (2012) Self-reported smoking status and plasma cotinine concentrations among pregnant women in the Norwegian Mother and Child Cohort Study. Pediatr Res 72, 101107.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Yang supplementary material
Table S1

 Word (29 KB)
29 KB

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed