Iron Status Indicators in Women with Prior Neural Tube Defect-Affected Pregnancies
Objectives: Iron deficiency is the most common nutrient deficiency in pregnant women and has been linked to negative impacts on the fetus. We describe the association of various iron-deficiency indices with risk of neural tube defect (NTD) among a high-risk Mexican-American population. Methods: The study included 158 case-women (NTD-affected pregnancies) and 189 control-women (normal births) who were residents of the 14 Texas–Mexico border counties and delivered or terminated pregnancies during 1995–2000. In-person interviews and laboratory assays provided data. Results: Case-women had higher odds of having minimal or no iron stores (serum ferritin <30 μg/L) compared to control-women (OR = 1.8, 95% CI = 1.0–3.3). The risk effect was not explained by low folate or B12 or other risk factors. Conclusion: Low serum ferritin may reflect the additive effect of multiple long-term factors, many of them related to poverty such as poor quality diet, lack of supplementation, and frequent pregnancies. Interpartum care is indicated in this population.
- 1.Lee GR. The anemias associated with renal disease, liver disease, endocrine disease, and pregnancy. In: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM, editors. Wintrobe's clinical heamatology, Vol. 2. (10th ed.) Philadelphia, PA: Lippincott Williams and Wilkins, 1999:Chapter 57.Google Scholar
- 2.Hillman RS. Hematopoietic agents: Growth factors, minerals, and vitamins. In: Hardman JG, Limbird LE, (Eds.) Goodman & Gilman's the pharmacological basis of therapeutics. (10th ed.) New York: McGraw-Hill, 2001:Chapter 54.Google Scholar
- 3.Mason JB. Consequences of altered micronutrient status. In: Goldman L, Bennett JC, (Eds.) Cecil textbook of medicine, Vol. 2. (21st ed.) Philadelphia, PA: W.B. Saunders Company, 2000:Chapter 231.Google Scholar
- 18.Nutrition during pregnancy. Part I: Weight gain. Part II: Nutrition supplements. Washington, DC: Institute of Medicine, National Academy of Sciences, 1990.Google Scholar
- 21.Suarez L, Felkner M, Hendricks K. The effect of fever, febrile illnesses, and heat exposures on the risk of neural tube defects in a Texas-Mexico border population. Birth Defects Res (Part A) (in press).Google Scholar
- 25.Elwood M, Little J. Maternal age and reproductive history. In: Elwood JM, Little J, Elwood JH, (Eds.) Epidemiology and control of neural tube defects. Oxford: Oxford University Press, 1992.Google Scholar