Skip to main content
×
×
Home

Haemoconcentration risk at the end of pregnancy: effects on neonatal behaviour

  • Nuria Aranda (a1) (a2), Carmen Hernández-Martínez (a3) (a2), Victoria Arija (a1) (a4) (a2), Blanca Ribot (a1) (a2) and Josefa Canals (a3) (a2)...
Abstract
Objective

To determine the associations between haemoconcentration at the end of pregnancy (third trimester and delivery) and neonatal behaviour in healthy pregnant women supplemented with moderate doses of Fe.

Design

A prospective longitudinal study in which obstetric and clinical history, maternal toxic habits, maternal anxiety and Hb levels were recorded at the third trimester and delivery. Neonatal behaviour was assessed at 48–72 h of age using the Neonatal Behavioral Assessment Scale.

Setting

Unit of Obstetrics and Gynaecology of the Sant Joan University Hospital in Reus, Tarragona (Spain).

Subjects

A total of 210 healthy and well-nourished pregnant women and their full-term, normal-weight newborns.

Results

The results showed that, after adjusting for confounders, in the third trimester the risk of haemoconcentration (6·2 % of pregnant women) was related to decreased neonatal state regulation (B=−1·273, P=0·006) and alertness (B=−1·848, P=0·006) scores. In addition, the risk of haemoconcentration at delivery (12·0 % of pregnant women) was also related to decreased neonatal state regulation (B=−0·796, P=0·021) and poor robustness and endurance (B=−0·921, P=0·005) scores.

Conclusions

Our results show that the risk of haemoconcentration at the end of pregnancy is related to the neonate’s neurodevelopment (and self-regulation capabilities), suggesting that Fe supplementation patterns and maternal Fe status during pregnancy are important factors for neurodevelopment which may be carefully controlled.

  • 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.

      Haemoconcentration risk at the end of pregnancy: effects on neonatal behaviour
      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.

      Haemoconcentration risk at the end of pregnancy: effects on neonatal behaviour
      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.

      Haemoconcentration risk at the end of pregnancy: effects on neonatal behaviour
      Available formats
      ×
Copyright
Corresponding author
* Corresponding author: Email josefa.canals@urv.cat
Footnotes
Hide All

These authors contributed equally to this work.

Footnotes
References
Hide All
1. World Health Organization (2008) Worldwide Prevalence of Anaemia 1993–2005. WHO Global Database on Anaemia. Geneva: WHO.
2. Aranda, N, Ribot, B, Garcia, E et al. (2011) Pre-pregnancy iron reserves, iron supplementation during pregnancy, and birth weight. Early Hum Dev 87, 791797.
3. Rasmussen, K (2001) Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality? J Nutr 131, 2S-2, 590S601S.
4. Ribot, B, Aranda, N, Viteri, F et al. (2012) Depleted iron stores without anaemia early in pregnancy carries increased risk of lower birthweight even when supplemented daily with moderate iron. Hum Reprod 27, 12601266.
5. Allen, LH (1993) Iron deficiency anemia increases risk of preterm delivery. Nutr Rev 51, 4952.
6. 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.
7. Oyemade, UJ, Cole, OJ, Johnson, AA et al. (1994) Prenatal predictors of performance on the Brazelton neonatal behavioural assessment scale. J Nutr 124, 6 Suppl, 1000S1005S.
8. Thompson, RA & Nelson, CA (2001) Developmental science and the media: early brain development. Am Psychol 56, 515.
9. Cucó, G, Fernandez-Ballart, J, Arija, V et al. (2005) Effect of B1-, B6- and iron intake during pregnancy on neonatal behavior. Int J Vitam Nutr Res 75, 320326.
10. Hernández-Martínez, C, Canals, J, Aranda, N et al. (2011) Effects of iron deficiency on neonatal behavior at different stages of pregnancy. Early Hum Dev 87, 165169.
11. Georgieff, MK & Rao, R (2001) The role of nutrition in cognitive development. In Handbook in Developmental Cognitive Neuroscience, pp. 491504 [CA Nelson and M Luciana, editors]. Cambridge, MA: MIT Press.
12. Casanueva, E & Viteri, FE (2003) Iron and oxidative stress in pregnancy. J Nutr 133, 5 Suppl. 2, 1700S1708S.
13. Aranda, N, Ribot, B, Viteri, F et al. (2013) Predictors of haemoconcentration at delivery: association with low birth weight. Eur J Nutr 52, 16311639.
14. Arija, V, Ribot, B & Aranda, N (2013) Prevalence of iron deficiency states and risk of haemoconcentration during pregnancy according to initial iron stores and iron supplementation. Public Health Nutr 16, 13711378.
15. Aisen, P, Cohen, G & Kang, JO (1990) Iron toxicosis. Int Rev Exp Pathol 31, 146.
16. Casanueva, E, Viteri, F, Mares-Galindo, M et al. (2006) Weekly iron as a safe alternative to daily supplementation for nonanemic pregnant women. Arch Med Res 37, 674–668.
17. Papadopoulou, E, Stratakis, N, Roumeliotaki, T et al. (2013) The effect of high doses of folic acid and iron supplementation in early-to-mid pregnancy on prematurity and fetal growth retardation: the mother–child cohort study in Crete, Greece (Rhea study). Eur J Nutr 52, 326336.
18. Khambalia, AZ, Aimone, A, Nagubandi, P et al. (2016) 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.
19. Sandstrom, B (2001) Micronutrient interactions: effects on absorption and bioavailability. Br J Nutr 85, Suppl. 2, S181S185.
20. Ziaei, S, Norrozi, M, Faghihzadeh, S et al. (2007) A randomised placebo-controlled trial to determine the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin ≥13.2 g/dl. BJOG 114, 684688.
21. Gaillard, R, Eilers, PH, Yassine, S et al. (2014) Risk factors and consequences of maternal anaemia and elevated haemoglobin levels during pregnancy: a population-based prospective cohort study. Paediatr Perinat Epidemiol 28, 213226.
22. Cordina, M, Bhatti, S, Fernandez, M et al. (2015) Association between maternal haemoglobin at 27–29 weeks gestation and intrauterine growth restriction. Pregnancy Hypertens 5, 339345.
23. Steer, P, Alam, MA, Wadsworth, J et al. (1995) Relation between maternal haemoglobin concentration and birth weight in different ethnic groups. BMJ 310, 489491.
24. Peña-Rosas, J & Viteri, F (2009) Effects and safety of preventive oral iron or iron + folic acid supplementation for women during pregnancy. Cochrane Database Syst Rev issue 4, CD004736.
25. Cung, TG, Paus, AS, Aghbar, A et al. (2014) Stillbirths at a hospital in Nablus, 2010: a cohort study. Glob Health Action 7, 25222.
26. Ellison, PT (2010) Fetal programming and fetal psychology. Infant Child Dev 19, 620.
27. Massaro, AN, Rothbaum, R & Aly, H (2006) Fetal brain development: the role of maternal nutrition, exposures and behaviors. Eur J Paediatr Neurol 4, 19.
28. Tamura, T, Goldenberg, RL, Hou, J et al. (2002) Cord serum ferritin concentrations and mental and psychomotor development of children at five years of age. J Pediatr 140, 165170.
29. Hanieh, S, Ha, TT, Simpson, JA et al. (2013) The effect of intermittent antenatal iron supplementation on maternal and infant outcomes in rural Viet Nam: a cluster randomised trial. PLoS Med 10, e1001470.
30. Hernández-Martínez, C, Arija, V, Balaguer, A et al. (2008) Do the emotional states of pregnant women affect neonatal behavior? Early Hum Dev 84, 745750.
31. Hernández-Martínez, C, Arija, V, Escribano, J et al. (2010) Does maternal anxiety affect neonatal behaviour differently in boys and girls? Early Hum Dev 86, 209211.
32. Conroy, S, Pariante, CM, Marks, MN et al. (2012) Maternal psychopathology and infant development at 18 months: the impact of maternal personality disorder and depression. J Am Acad Child Adolesc Psychiatry 51, 5161.
33. Koutra, K, Chatzi, L, Roumeliotaki, T et al. (2012) Socio-demographic determinants of infant neurodevelopment at 18 months of age: Mother–Child Cohort (Rhea Study) in Crete, Greece. Infant Behav Dev 35, 4859.
34. Ding, Y, Xu, X, Wang, Z et al. (2014) The relation of infant attachment to attachment and cognitive and behavioural outcomes in early childhood. Early Hum Dev 90, 459464.
35. Victora, CG, Horta, BL, de Mola, CL et al. (2015) Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil. Lancet Glob Health 3, e199e205.
36. Angulo-Barroso, RM, Schapiro, L, Liang, W et al. (2011) Motor development in 9-month-old infants in relation to cultural differences and iron status. Dev Psychobiol 53, 196210.
37. Hernández-Martínez, C, Arija, V, Escribano, J et al. (2012) A longitudinal study on the effects of maternal smoking and secondhand smoke exposure during pregnancy on neonatal neurobehavior. Early Hum Dev 88, 403408.
38. Georgieff, MK (2007) Nutrition and the developing brain: nutrient priorities and measurement. Am J Clin Nutr 85, issue 2, 614S620S.
39. Dobbing, JN & Sands, J (1973) Quantitative growth and development of human brain. Arch Dis Child 48, 757767.
40. Rao, R & Georgieff, MK (2000) Early nutrition and brain development. In The Effects of Early Adversity on Neurobehavioral Development. Symposium on Child Psychology , pp. 130 [CA Nelson, editor]. Hillsdale, NJ: Erlbaum Associates.
41. Chen, X, Scholl, TO & Stein, TP (2006) Association of elevated serum ferritin levels and the risk of gestational diabetes mellitus in pregnant women: the Camden study. Diabetes Care 29, 10771082.
42. Rambod, M, Kovesdy, CP & Kalantar-Zadeh, K (2008) Combined high serum ferritin and low iron saturation in hemodialysis patients: the role of inflammation. Clin J Am Soc Nephrol 3, 16911701.
43. Ministerio de Sanidad y Consumo (2006) Guía para la Prevención de Defectos Congénitos. Madrid: Ministerio de Sanidad y Consumo; available at http://www.msssi.gob.es/profesionales/prestacionesSanitarias/publicaciones/DefectosCongenitos.htm
44. Gomez, F, Simo, JM, Camps, J et al. (2000) Evaluation of a particle-enhanced turbidimetric immunoassay for the measurement of ferritin: application to patients participating in an autologous blood transfusion program. Clin Biochem 33, 191196.
45. World Health Organization (2011) Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Vitamin and Mineral Nutrition Information System. Geneva: WHO.
46. World Health Organization, United Nations University & UNICEF (2001) Iron Deficiency Anaemia: Assessment, Prevention, and Control. A Guide for Programme Managers. WHO/NHD/01.3. Geneva: WHO.
47. Brazelton, TB & Nugent, JK (1997) Escala para la Evaluación del Comportamiento Neonatal. Barcelona: Paidós.
48. Spielberger, CD, Gorsuch, RL & Lushene, RE (1994) STAI Cuestionario de Ansiedad Estado Rasgo [adaptación española: Nicolás Seisdedos Cubero]. Madrid: TEA Ediciones.
49. Hollingshead, AB (2011) Four factor index of social status. Yale J Sociol 8, 2152.
50. World Health Organization (2006) Iron and Folate Supplementation. Standards for Maternal and Neonatal Care. Integrated Management of Pregnancy and Childbirth (IMPAC). Geneva: WHO.
51. Aranda, N, Viteri, FE, Montserrat, C et al. (2010) Effects of C282Y, H63D, and S65C HFE gene mutations, diet, and life-style factors on iron status in a general Mediterranean population from Tarragona, Spain. Ann Hematol 89, 767773.
52. Aranda, N, Viteri, FE, Fernández-Ballart, J et al. (2007) Frequency of the hemochromatosis gene (HFE) 282C→Y, 63H→D, and 65S→C mutations in a general Mediterranean population from Tarragona, Spain. Ann Hematol 86, 1721.
53. Walsh, T, O’Broin, SD, Cooley, S et al. (2011) Laboratory assessment of iron status in pregnancy. Clin Chem Lab Med 49, 12251230.
54. Yip, R (2000) Significance of an abnormally low or high hemoglobin concentration during pregnancy: special consideration of iron nutrition. Am J Clin Nutr 72, 1 Suppl., 272S279S.
55. Scholl, TO (2005) Iron status during pregnancy: setting the stage for mother and infant. Am J Clin Nutr 81, issue 5, 1218S1222S.
56. Brazelton, TB & Nugent, JK (2011) The Neonatal Behavioral Assessment Scale, 4th ed. Cambridge: Mac Keith Press.
57. Debnath, M, Venkatasubramanian, G & Berk, M (2015) Fetal programming of schizophrenia: select mechanisms. Neurosci Biobehav Rev 49, 90104.
58. Kingston, D, McDonald, S, Austin, M et al. (2015) Association between prenatal and postnatal psychological distress and toddler cognitive development: a systematic review. PLoS One 10, e126929.
59. Glover, V (2014) Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol 28, 2535.
60. O’Donnell, KJ, Glover, V, Barker, ED et al. (2014) The persisting effect of maternal mood in pregnancy on childhood psychopathology. Dev Psychopathol 26, 393403.
61. Yang, L, Ren, AG, Liu, JM et al. (2010) Influence of hemoglobin level during early gestation on the development of cognition of pre-school children. Zhonghua Liu Xing Bing Xue Za Zhi 31, 13531358.
62. Canals, J, Hernández-Martínez, C, Esparó, G et al. (2011) Neonatal Behavioral Assessment Scale as a predictor of cognitive development and IQ in full-term infants: a 6-year longitudinal study. Acta Paediatr 100, 13311337.
63. Canals, J, Esparó, G & Fernández-Ballart, JD (2006) Neonatal behaviour characteristics and psychological problems at 6 years. Acta Paediatr 95, 14121417.
64. Barker, DJ (1998) In utero programming of chronic disease. Clin Sci (Lond) 95, 115128.
65. Iwamoto, HS, Murray, MA & Chernausek, SD (1992) Effects of acute hypoxemia on insulin-like growth factors and their binding proteins in fetal sheep. Am J Physiol 263, 11511156.
66. Kim-Shapiro, DB, Schechter, AN & Gladwin, MT (2006) Unraveling the reactions of nitric oxide, nitrite, and hemoglobin in physiology and therapeutics. Arterioscler Thromb Vasc Biol 26, 697705.
67. Sun, L, Macgowan, CK, Sled, JG et al. (2015) Reduced fetal cerebral oxygen consumption is associated with smaller brain size in fetuses with congenital heart disease. Circulation 131, 13131323.
68. Walter, PB, Knutson, MD, Paler-Martinez, A et al. (2002) Iron deficiency and iron excess damage mitochondria and mitochondrial DNA in rats. Proc Natl Acad Sci U S A 99, 22642269.
69. Viteri, FE, Casanueva, E, Tolentino, MC et al. (2012) Antenatal iron supplements consumed daily produce oxidative stress in contrast to weekly supplementation in Mexican non-anemic women. Reprod Toxicol 34, 125132.
70. Peña-Rosas, JP, De-Regil, LM, Gomez Malave, H et al. (2015) Intermittent oral iron supplementation during pregnancy. Cochrane Database Syst Rev issue 10, CD009997.
71. Shen, Y, Yu, HM, Yuan, TM et al. (2007) Intrauterine infection induced oligodendrocyte injury and inducible nitric oxide synthase expression in the developing rat brain. J Perinat Med 35, 203209.
72. Ribot, B, Aranda, N, Giralt, M et al. (2013) Effect of different doses of iron supplementation during pregnancy on maternal and infant health. Ann Hematol 92, 221229.
Recommend this journal

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

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 14
Total number of PDF views: 64 *
Loading metrics...

Abstract views

Total abstract views: 404 *
Loading metrics...

* Views captured on Cambridge Core between 6th February 2017 - 23rd May 2018. This data will be updated every 24 hours.