Fe deficiency anaemia during early pregnancy has been linked with low birth
weight and preterm birth. However, this evidence comes mostly from studies
measuring Hb levels rather than specific measures of Fe deficiency. The present
study aimed to examine the association between maternal Fe status during the
first trimester of pregnancy, as assessed by serum ferritin, transferrin
receptor and their ratio, with size at birth and preterm birth. In the Baby VIP
(Baby's Vascular health and Iron in Pregnancy) study, we recruited 362
infants and their mothers after delivery in Leeds, UK. Biomarkers were measured
in maternal serum samples previously obtained in the first trimester of
pregnancy. The cohort included sixty-four (18 %) small for gestational
age (SGA) babies. Thirty-three babies were born preterm (9 %; between 34
and 37 weeks). First trimester maternal Fe depletion was associated with a
higher risk of SGA (adjusted OR 2·2, 95 % CI 1·1,
4·1). This relationship was attenuated when including early pregnancy Hb
in the model, suggesting it as a mediator (adjusted OR 1·6, 95 %
CI 0·8, 3·2). For every 10 g/l increase in maternal Hb
level in the first half of pregnancy the risk of SGA was reduced by 30 %
(adjusted 95 % CI 0, 40 %); levels below 110 g/l were
associated with a 3-fold increase in the risk of SGA (95 % CI 1·0,
9·0). There was no evidence of association between maternal Fe depletion
and preterm birth (adjusted OR 1·5, 95 % 0·6, 3·8).
The present study shows that depleted Fe stores in early pregnancy are
associated with higher risk of SGA.