1
|
Arcagok BC, Bilgen H, Ozdemir H, Memisoglu A, Save D, Ozek E. Early or delayed cord clamping during transition of term newborns: does it make any difference in cerebral tissue oxygenation? Ital J Pediatr 2024; 50:133. [PMID: 39075594 PMCID: PMC11288115 DOI: 10.1186/s13052-024-01707-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 07/16/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND According to the World Health Organization's recommendation, delayed cord clamping in term newborns can have various benefits. Cochrane metaanalyses reported no differences for mortality and early neonatal morbidity although a limited number of studies investigated long-term neurodevelopmental outcomes. The aim of our study is to compare the postnatal cerebral tissue oxygenation values in babies with early versus delayed cord clamping born after elective cesarean section. METHODS In this study, a total of 80 term newborns delivered by elective cesarean section were included. Infants were randomly grouped as early (clamped within 15 s, n:40) and delayed cord clamping (at the 60th second, n:40) groups. Peripheral arterial oxygen saturation (SpO2) and heart rate were measured by pulse oximetry while regional oxygen saturation of the brain (rSO2) was measured with near-infrared spectrometer. Fractional tissue oxygen extraction (FTOE) was calculated for every minute between the 3rd and 15th minute after birth. (FTOE = pulse oximetry value-rSO2/pulse oximetry value). The measurements were compared for both groups. RESULTS The demographical characteristics, SpO2 levels (except postnatal 6th, 8th, and 14th minutes favoring DCC p < 0.05), heart rates and umbilical cord blood gas values were not significantly different between the groups (p > 0.05). rSO2 values were significantly higher while FTOE values were significantly lower for every minute between the 3rd and 15th minutes after birth in the delayed cord clamping group (p < 0.05). CONCLUSION Our study revealed a significant increase in cerebral rsO2 values and a decrease in FTOE values in the delayed cord clamping (DCC) group, indicating a positive impact on cerebral oxygenation and hemodynamics. Furthermore, the DCC group exhibited a higher proportion of infants with cerebral rSO2 levels above the 90th percentile. This higher proportion, along with a lower of those with such parameter below the 10th percentile, suggest that DCC may lead to the targeted/optimal cerebral oxygenetaion of these babies. As a result, we recommend measuring cerebral oxygenation, in addition to peripheral SpO2, for infants experiencing perinatal hypoxia and receiving supplemental oxygen.
Collapse
Affiliation(s)
- Baran Cengiz Arcagok
- Department of Pediatrics, Division of Neonatology, School of Medicine, Acibadem University, Istanbul, Turkey.
| | - Hulya Bilgen
- Department of Pediatrics, Division of Neonatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Hulya Ozdemir
- Department of Pediatrics, Division of Neonatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Asli Memisoglu
- Department of Pediatrics, Division of Neonatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Dilsad Save
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
| | - Eren Ozek
- Department of Pediatrics, Division of Neonatology, School of Medicine, Marmara University, Istanbul, Turkey
| |
Collapse
|
2
|
Ringshaw JE, Hendrikse C, Wedderburn CJ, Bradford LE, Williams SR, Nyakonda CN, Subramoney S, Lake MT, Burd T, Hoffman N, Roos A, Narr KL, Joshi SH, Williams SCR, Zar HJ, Stein DJ, Donald KA. Persistent Impact of Antenatal Maternal Anaemia on Child Brain Structure at 6-7 Years of Age: A South African Child Health Study. RESEARCH SQUARE 2024:rs.3.rs-4281448. [PMID: 38746172 PMCID: PMC11092825 DOI: 10.21203/rs.3.rs-4281448/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background The study aim was to determine whether associations of antenatal maternal anaemia with smaller corpus callosum, putamen, and caudate nucleus volumes previously described in children at age 2-3 years persist to age 6-7 years in the Drakenstein Child Health Study (DCHS). Methods This neuroimaging sub-study was nested within the DCHS, a South African population-based birth cohort. Pregnant women were enrolled (2012-2015) and mother-child dyads were followed prospectively. A sub-group of children had magnetic resonance imaging at 6-7 years of age (2018-2022). Mothers had haemoglobin measurements during pregnancy and a proportion of children were tested postnatally. Maternal anaemia (haemoglobin<11g/dL) and child anaemia were classified using WHO and local guidelines. Linear modeling was used to investigate associations between antenatal maternal anaemia status, maternal haemoglobin concentrations, and regional child brain volumes. Models included potential confounders and were conducted with and without child anaemia to assess the relative roles of antenatal versus postnatal anaemia. Results Overall, 157 children (Mean [SD] age of 75.54 [4.77] months; 84 [53.50%] male) were born to mothers with antenatal haemoglobin data. The prevalence of maternal anaemia during pregnancy was 31.85% (50/157). In adjusted models, maternal anaemia status was associated with smaller volumes of the total corpus callosum (adjusted percentage difference, -6.77%; p=0.003), left caudate nucleus (adjusted percentage difference, -5.98%, p=0.005), and right caudate nucleus (adjusted percentage difference, -6.12%; p=0.003). Continuous maternal haemoglobin was positively associated with total corpus callosum (β=0.239 [CI: 0.10 to 0.38]; p<0.001) and caudate nucleus (β=0.165 [CI: 0.02 to 0.31]; p=0.027) volumes. In a sub-group (n=89) with child haemoglobin data (Mean [SD] age of 76.06[4.84]), the prevalence of antenatal maternal anaemia and postnatal child anaemia was 38.20% (34/89) and 47.19% (42/89), respectively. There was no association between maternal and child anaemia (c2 = 0.799; p=0.372), and child anaemia did not contribute to regional brain volume differences associated with maternal anaemia. Conclusions Associations between maternal anaemia and regional child brain volumes previously reported at 2-3 years of age were consistent and persisted to 6-7 years of age. Findings support the importance of optimizing antenatal maternal health and reinforce these brain regions as a future research focus on intervention outcomes.
Collapse
Affiliation(s)
- Jessica E Ringshaw
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town
| | - Chanelle Hendrikse
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town
| | - Catherine J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town
| | - Layla E Bradford
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town
| | - Simone R Williams
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town
| | - Charmaine N Nyakonda
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town
| | - Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town
| | - Marilyn T Lake
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town
| | - Tiffany Burd
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town
| | - Nadia Hoffman
- Department of Psychiatry & Mental Health, University of Cape Town
| | - Annerine Roos
- South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute
| | | | | | - Steven C R Williams
- Centre for Neuroimaging Sciences, Department of Neuroimaging, Kings College London
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town
| | - Dan J Stein
- South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town
| |
Collapse
|
3
|
Rao RB. Biomarkers of Brain Dysfunction in Perinatal Iron Deficiency. Nutrients 2024; 16:1092. [PMID: 38613125 PMCID: PMC11013337 DOI: 10.3390/nu16071092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Iron deficiency in the fetal and neonatal period (perinatal iron deficiency) bodes poorly for neurodevelopment. Given its common occurrence and the negative impact on brain development, a screening and treatment strategy that is focused on optimizing brain development in perinatal iron deficiency is necessary. Pediatric societies currently recommend a universal iron supplementation strategy for full-term and preterm infants that does not consider individual variation in body iron status and thus could lead to undertreatment or overtreatment. Moreover, the focus is on hematological normalcy and not optimal brain development. Several serum iron indices and hematological parameters in the perinatal period are associated with a risk of abnormal neurodevelopment, suggesting their potential use as biomarkers for screening and monitoring treatment in infants at risk for perinatal iron deficiency. A biomarker-based screening and treatment strategy that is focused on optimizing brain development will likely improve outcomes in perinatal iron deficiency.
Collapse
Affiliation(s)
- Raghavendra B. Rao
- Division of Neonatology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
- Masonic Institute for the Developing Brain, Minneapolis, MN 55414, USA
| |
Collapse
|
4
|
Marcora MS, Mattera VS, Goñi P, Aybar F, Correale JD, Pasquini JM. Iron deficiency in astrocytes alters cellular status and impacts on oligodendrocyte differentiation. J Neurosci Res 2024; 102:e25334. [PMID: 38656648 DOI: 10.1002/jnr.25334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
Iron deficiency (ID) has been shown to affect central nervous system (CNS) development and induce hypomyelination. Previous work from our laboratory in a gestational ID model showed that both oligodendrocyte (OLG) and astrocyte (AST) maturation was impaired. To explore the contribution of AST iron to the myelination process, we generated an in vitro ID model by silencing divalent metal transporter 1 (DMT1) in AST (siDMT1 AST) or treating AST with Fe3+ chelator deferoxamine (DFX; DFX AST). siDMT1 AST showed no changes in proliferation but remained immature. Co-cultures of oligodendrocyte precursors cells (OPC) with siDMT1 AST and OPC cultures incubated with siDMT1 AST-conditioned media (ACM) rendered a reduction in OPC maturation. These findings correlated with a decrease in the expression of AST-secreted factors IGF-1, NRG-1, and LIF, known to promote OPC differentiation. siDMT1 AST also displayed increased mitochondrial number and reduced mitochondrial size as compared to control cells. DFX AST also remained immature and DFX AST-conditioned media also hampered OPC maturation in culture, in keeping with a decrease in the expression of AST-secreted growth factors IGF-1, NRG-1, LIF, and CNTF. DFX AST mitochondrial morphology and number showed results similar to those observed in siDMT1 AST. In sum, our results show that ID, induced through two different methods, impacts AST maturation and mitochondrial functioning, which in turn hampers OPC differentiation.
Collapse
Affiliation(s)
- María Silvina Marcora
- Departamento de Química Biológica e Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Vanesa Soledad Mattera
- Departamento de Química Biológica e Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Pilar Goñi
- Departamento de Química Biológica e Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Florencia Aybar
- Departamento de Química Biológica e Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Jorge Daniel Correale
- Departamento de Neurología, Fleni e Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Juana Maria Pasquini
- Departamento de Química Biológica e Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| |
Collapse
|
5
|
Levi S, Ripamonti M, Moro AS, Cozzi A. Iron imbalance in neurodegeneration. Mol Psychiatry 2024; 29:1139-1152. [PMID: 38212377 PMCID: PMC11176077 DOI: 10.1038/s41380-023-02399-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
Iron is an essential element for the development and functionality of the brain, and anomalies in its distribution and concentration in brain tissue have been found to be associated with the most frequent neurodegenerative diseases. When magnetic resonance techniques allowed iron quantification in vivo, it was confirmed that the alteration of brain iron homeostasis is a common feature of many neurodegenerative diseases. However, whether iron is the main actor in the neurodegenerative process, or its alteration is a consequence of the degenerative process is still an open question. Because the different iron-related pathogenic mechanisms are specific for distinctive diseases, identifying the molecular mechanisms common to the various pathologies could represent a way to clarify this complex topic. Indeed, both iron overload and iron deficiency have profound consequences on cellular functioning, and both contribute to neuronal death processes in different manners, such as promoting oxidative damage, a loss of membrane integrity, a loss of proteostasis, and mitochondrial dysfunction. In this review, with the attempt to elucidate the consequences of iron dyshomeostasis for brain health, we summarize the main pathological molecular mechanisms that couple iron and neuronal death.
Collapse
Affiliation(s)
- Sonia Levi
- Vita-Salute San Raffaele University, Milano, Italy.
- IRCCS San Raffaele Scientific Institute, Milano, Italy.
| | | | - Andrea Stefano Moro
- Vita-Salute San Raffaele University, Milano, Italy
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Anna Cozzi
- IRCCS San Raffaele Scientific Institute, Milano, Italy
| |
Collapse
|
6
|
Hossain A, Rahman S, Akter S, Jahan I, Dey SK, Mannan A, Shahidullah M. Assessment of iron status and red cell parameters in healthy term small for gestational age neonates at birth. Clin Exp Pediatr 2024; 67:221-223. [PMID: 38500237 PMCID: PMC10990652 DOI: 10.3345/cep.2023.01445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/27/2024] [Accepted: 03/07/2024] [Indexed: 03/20/2024] Open
Affiliation(s)
- Arif Hossain
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Shorna Rahman
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Shahana Akter
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Ismat Jahan
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Sanjoy Kumer Dey
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Abdul Mannan
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Mohammod Shahidullah
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| |
Collapse
|
7
|
Hao X, Guo Y, Lu J, Zhu L, Yan S, Tao F, Huang K. Sex-specific association between maternal mild anemia and children's behavioral development: a birth cohort study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02411-z. [PMID: 38517534 DOI: 10.1007/s00787-024-02411-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
There has been limited research on maternal anemia affecting children's behavioral development, with a lack of studies focusing on sex differences in this association. Based on the Ma'anshan Birth Cohort, 2132 mother-child pairs were included. Maternal anemia was evaluated based on the hemoglobin concentration and children's behavioral development was assessed by Achenbach Child Behavior Checklist 1.5-5. Binary logistic regression models indicated that compared with children born of mothers without anemia throughout pregnancy, maternal mild anemia during pregnancy or only anemia in the 3rd trimester was associated with increased risks of aggressive behaviors in boys. Maternal mild anemia only in the 2nd trimester was associated with increased risks of attention problems in boys. In girls, maternal mild anemia during pregnancy was associated with increased risks of withdrawn, internalizing problems and total problems. Girls born of mothers with mild anemia only in the 2nd trimester had higher risks of total problems. Maternal mild anemia in both 2nd and 3rd trimesters was associated with increased risks of internalizing problems in girls. Our study identified sex-specific effects of maternal mild anemia during pregnancy on children's behavioral development problems.
Collapse
Affiliation(s)
- Xuemei Hao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yufan Guo
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jingru Lu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Linlin Zhu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Center, Ma'anshan, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China.
| |
Collapse
|
8
|
Iglesias‐Vázquez L, Canals J, Hernández‐Martínez C, Voltas N, Arija V. Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4-year-old children. MATERNAL & CHILD NUTRITION 2024; 20:e13595. [PMID: 38041537 PMCID: PMC10750013 DOI: 10.1111/mcn.13595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4-year follow-up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110-130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF < 15 µg/L), normal (SF = 15-65 µg/L), and normal-high (SF > 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5-5 years and the Behaviour Rating Inventory of Executive Function-Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5-5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal-high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF < 15 µg/L. Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4-year-old children.
Collapse
Affiliation(s)
- Lucía Iglesias‐Vázquez
- Department of Basic Medical Sciences, Nutrition and Mental Health (NUTRISAM) Research GroupUniversitat Rovira I VirgiliReusSpain
- Institut d'Investigació Sanitaria Pere Virgili (IISPV)ReusSpain
| | - Josefa Canals
- Department of Basic Medical Sciences, Nutrition and Mental Health (NUTRISAM) Research GroupUniversitat Rovira I VirgiliReusSpain
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Faculty of Education Sciences and PsychologyUniversitat Rovira I VirgiliTarragonaSpain
| | - Carmen Hernández‐Martínez
- Department of Basic Medical Sciences, Nutrition and Mental Health (NUTRISAM) Research GroupUniversitat Rovira I VirgiliReusSpain
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Faculty of Education Sciences and PsychologyUniversitat Rovira I VirgiliTarragonaSpain
| | - Núria Voltas
- Department of Basic Medical Sciences, Nutrition and Mental Health (NUTRISAM) Research GroupUniversitat Rovira I VirgiliReusSpain
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Faculty of Education Sciences and PsychologyUniversitat Rovira I VirgiliTarragonaSpain
- Department of Psychology, Faculty of Education Sciences and Psychology, Serra Húnter FellowUniversitat Rovira I VirgiliTarragonaSpain
| | - Victoria Arija
- Department of Basic Medical Sciences, Nutrition and Mental Health (NUTRISAM) Research GroupUniversitat Rovira I VirgiliReusSpain
- Institut d'Investigació Sanitaria Pere Virgili (IISPV)ReusSpain
- Collaborative Research Group on Lifestyles, Nutrition, and Smoking (CENIT), Tarragona‐Reus Research Support UnitIDIAP Jordi GolTarragonaSpain
| |
Collapse
|
9
|
Gundacker A, Glat M, Wais J, Stoehrmann P, Pollak A, Pollak DD. Early-life iron deficiency persistently disrupts affective behaviour in mice. Ann Med 2023; 55:1265-1277. [PMID: 37096819 PMCID: PMC10132221 DOI: 10.1080/07853890.2023.2191003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/09/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND/OBJECTIVE Iron deficiency (ID) is the most common nutrient deficiency, affecting two billion people worldwide, including about 30% of pregnant women. During gestation, the brain is particularly vulnerable to environmental insults, which can irrevocably impair critical developmental processes. Consequently, detrimental consequences of early-life ID for offspring brain structure and function have been described. Although early life ID has been associated with an increased long-term risk for several neuropsychiatric disorders, the effect on depressive disorders has remained unresolved. MATERIALS AND METHODS A mouse model of moderate foetal and neonatal ID was established by keeping pregnant dams on an iron-deficient diet throughout gestation until postnatal day 10. The ensuing significant decrease of iron content in the offspring brain, as well as the impact on maternal behaviour and offspring vocalization was determined in the first postnatal week. The consequences of early-life ID for depression- and anxiety-like behaviour in adulthood were revealed employing dedicated behavioural assays. miRNA sequencing of hippocampal tissue of offspring revealed specific miRNAs signatures accompanying the behavioural deficits of foetal and neonatal ID in the adult brain. RESULTS Mothers receiving iron-deficient food during pregnancy and lactation exhibited significantly less licking and grooming behaviour, while active pup retrieval and pup ultrasonic vocalizations were unaltered. Adult offspring with a history of foetal and neonatal ID showed an increase in depression- and anxiety-like behaviour, paralleled by a deranged miRNA expression profile in the hippocampus, specifically levels of miR200a and miR200b. CONCLUSION ID during the foetal and neonatal periods has life-long consequences for affective behaviour in mice and leaves a specific and persistent mark on the expression of miRNAs in the brain. Foetal and neonatal ID needs to be further considered as risk factor for the development of depression and anxiety disorders later in life.Key MessagesMarginal reduction of gestational alimentary iron intake decreases brain iron content of the juvenile offspring.Early-life ID is associated with increased depression- and anxiety-like behaviour in adulthood.Reduction of maternal alimentary iron intake during pregnancy is reflected in an alteration of miRNA signatures in the adult offspring brain.
Collapse
Affiliation(s)
- Anna Gundacker
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Micaela Glat
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Jonathan Wais
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Peter Stoehrmann
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Arnold Pollak
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Daniela D. Pollak
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
10
|
Cabral L, Calabro FJ, Rasmussen J, Foran W, Moore LA, Graham A, O'Connor TG, Wadhwa PD, Entringer S, Fair D, Buss C, Panigrahy A, Luna B. Gestational and postnatal age associations for striatal tissue iron deposition in early infancy. Dev Cogn Neurosci 2023; 63:101286. [PMID: 37549453 PMCID: PMC10423888 DOI: 10.1016/j.dcn.2023.101286] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023] Open
Abstract
Striatal development is crucial for later motor, cognitive, and reward behavior, but age-related change in striatal physiology during the neonatal period remains understudied. An MRI-based measure of tissue iron deposition, T2*, is a non-invasive way to probe striatal physiology neonatally, linked to dopaminergic processing and cognition in children and adults. Striatal subregions have distinct functions that may come online at different time periods in early life. To identify if there are critical periods before or after birth, we measured if striatal iron accrued with gestational age at birth [range= 34.57-41.85 weeks] or postnatal age at scan [range= 5-64 days], using MRI to probe the T2* signal in N = 83 neonates in three striatal subregions. We found iron increased with postnatal age in the pallidum and putamen but not the caudate. No significant relationship between iron and gestational age was observed. Using a subset of infants scanned at preschool age (N = 26), we show distributions of iron shift between time points. In infants, the pallidum had the least iron of the three regions but had the most by preschool age. Together, this provides evidence of distinct change for striatal subregions, a possible differentiation between motor and cognitive systems, identifying a mechanism that may impact future trajectories.
Collapse
Affiliation(s)
- Laura Cabral
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Finnegan J Calabro
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jerod Rasmussen
- Development, Health and Disease Research Program, University of California, Irvine, CA 92697, USA; Department of Pediatrics, University of California, Irvine, CA 92697, USA
| | - Will Foran
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lucille A Moore
- Masonic Institute for the Developing Brain, University of Minnesota, USA
| | - Alice Graham
- Department of Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA
| | - Thomas G O'Connor
- Departments of Psychiatry, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY 14642, USA
| | - Pathik D Wadhwa
- Development, Health, and Disease Research Program, Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA, USA; Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, CA, USA; Departments of Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Orange, CA, USA
| | - Sonja Entringer
- Development, Health, and Disease Research Program, Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA, USA; Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, CA, USA; Institute of Medical Psychology, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Damien Fair
- Masonic Institute for the Developing Brain, University of Minnesota, USA
| | - Claudia Buss
- Development, Health, and Disease Research Program, Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA, USA; Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, CA, USA; Institute of Medical Psychology, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ashok Panigrahy
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
11
|
Iglesias-Vázquez L, Voltas N, Hernández-Martínez C, Canals J, Coronel P, Gimeno M, Basora J, Arija V. Importance of Maternal Iron Status on the Improvement of Cognitive Function in Children After Prenatal Iron Supplementation. Am J Prev Med 2023; 65:395-405. [PMID: 36906495 DOI: 10.1016/j.amepre.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION The effectiveness of prenatal iron supplementation improves maternal hematological outcomes, but little research has focused on child outcomes. The objective of this study was to assess whether prenatal iron supplementation adjusted to maternal needs improves children's cognitive functioning. METHODS The analyses included a subsample of nonanemic pregnant women recruited in early pregnancy and their children aged 4 years (n=295). Data were collected between 2013 and 2017 in Tarragona (Spain). On the basis of hemoglobin levels before the 12th gestational week, women receive different iron doses: 80 vs 40 mg/d if hemoglobin is 110-130 g/L and 20 vs 40 mg/d if hemoglobin >130 g/L. Children's cognitive functioning was assessed using the Wechsler Preschool and Primary Scale of Intelligence-IV and Developmental Neuropsychological Assessment-II tests. The analyses were carried out in 2022 after the completion of the study. Multivariate regression models were performed for assessing the association between different doses of prenatal iron supplementation and children's cognitive functioning. RESULTS Taking 80 mg/d of iron was positively associated with all the scales of the Wechsler Preschool and Primary Scale of Intelligence-IV and Neuropsychological Assessment-II when mothers had initial serum ferritin <15 µg/L, but it was negatively associated with Verbal Comprehension Index, Working Memory Index, Processing Speed Index, and Vocabulary Acquisition Index from Wechsler Preschool and Primary Scale of Intelligence-IV and verbal fluency index from Neuropsychological Assessment-II when mothers showed initial serum ferritin >65 µg/L. In the other group, taking 20 mg/d of iron was positively associated with Working Memory Index, Intelligence Quotient, verbal fluency, and emotion recognition indices when women had initial serum ferritin >65 µg/L. CONCLUSIONS Prenatal iron supplementation adjusted to the maternal hemoglobin levels and baseline iron stores improves cognitive functioning in children aged 4 years.
Collapse
Affiliation(s)
- Lucía Iglesias-Vázquez
- Nutrition and Mental Health (NUTRISAM) research group, Rovira i Virgili University, Reus, Spain; Pere Virgili Institute of Health Research (IISPV), Reus, Spain
| | - Núria Voltas
- Nutrition and Mental Health (NUTRISAM) research group, Rovira i Virgili University, Reus, Spain; Department of Psychology, Faculty of Education Sciences and Psychology, Research Centre for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain; Serra Húnter Fellow, Department of Psychology, Faculty of Education Sciences and Psychology, Rovira i Virgili University, Tarragona, Spain
| | - Carmen Hernández-Martínez
- Nutrition and Mental Health (NUTRISAM) research group, Rovira i Virgili University, Reus, Spain; Department of Psychology, Faculty of Education Sciences and Psychology, Research Centre for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain
| | - Josefa Canals
- Nutrition and Mental Health (NUTRISAM) research group, Rovira i Virgili University, Reus, Spain; Department of Psychology, Faculty of Education Sciences and Psychology, Research Centre for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain
| | - Pilar Coronel
- Meiji Pharma Spain ES (formerly Tedec-Meiji Farma S.A), Alcalá de Henares, Madrid, Spain
| | - Mercedes Gimeno
- Meiji Pharma Spain ES (formerly Tedec-Meiji Farma S.A), Alcalá de Henares, Madrid, Spain
| | - Josep Basora
- Pere Virgili Institute of Health Research (IISPV), Reus, Spain; University Institute for Primary Health Care Research Foundation Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER Consortium, Physiopathology of Obesity and Nutrition (CIBERObn), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Victoria Arija
- Nutrition and Mental Health (NUTRISAM) research group, Rovira i Virgili University, Reus, Spain; Pere Virgili Institute of Health Research (IISPV), Reus, Spain; Collaborative Research Group on Lifestyles, Nutrition, and Smoking (CENIT), Tarragona-Reus Research Support Unit, Primary Care Research Institute (IDIAP) Jordi Gol, Tarragona, Spain.
| |
Collapse
|
12
|
Sarin V, Malhotra P, Kaur MJ, Kumar R, Narang GS. Association of Cord Ferritin Levels with Brain Stem Evoked Response Audiometry in Newborns. Indian J Otolaryngol Head Neck Surg 2023; 75:2201-2206. [PMID: 37636610 PMCID: PMC10447655 DOI: 10.1007/s12070-023-03658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 08/29/2023] Open
Abstract
Iron is an important nutrient and it plays a pivotal role in myelin formation and neurotransmitter synthesis, thus contributing to normal neurological activity. Ferritin is a reliable indicator of the tissue iron stores and in-utero stores can be well measured by cord ferritin levels. The objective of this study was to evaluate the effects of umbilical cord ferritin levels (CFL) on the brain stem evoked response audiometry (BERA) This prospective observational study was conducted in a tertiary care centre of North India with a sample size of 100 inborn neonates. After evaluation of the umbilical cord ferritin levels the study cohort was divided into Group A( UCF<75ng/ml) and Group B(UCF>75ng/dl). All subjects were subjected to BERA. A detailed analysis of CFL and BERA was done and statistically analysed. Neonates in group B had significantly prolonged absolute peak latency of wave I, III and V and interpeak latency of wave III-V when compared to group A. The Pearson correlation also showed negative correlation of CFL with absolute peak latency of wave I, III, and V and interpeak latency of wave III-V. Among the maternal and neonatal variables, highly significant correlation was noted between absolute latency of wave I, III and V, CFL and cord hematocrit. The Pearson correlation showed negative correlation of absolute peak latency of wave I, III and V with maternal haemoglobin (Hb), neonatal birth weight, CFL,s and cord hematocrit values. A negative Pearson correlation was noted between interpeak latency of wave III-V with neonatal birth weight and cord hematocrit level, interpeak latency of wave I-V with neonatal birth weight and between interpeak latency of wave I-III with cord hematocrit values. CFL's significantly affect the absolute peak latency of wave I, III and V and it also affects the interpeak latency of wave III-V. This may be attributed to slow conduction time secondary to altered myelination. CFL's should be considered as a routine protocol in neonates to detect early compromises in the process of myelination and brain maturation.
Collapse
Affiliation(s)
- Vanita Sarin
- Department of Otorhinolaryngology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Preeti Malhotra
- Department of Paediatrics, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Maninder jeet Kaur
- Department of Paediatrics, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Ravishankar Kumar
- Department of Otorhinolaryngology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Gursharan Singh Narang
- Department of Paediatrics, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| |
Collapse
|
13
|
Iglesias-Vázquez L, Suliburska J, Kocyłowski R, Bakinowska E, Arija V. Nutrient Intake among Pregnant Women in Spain and Poland: A Comparative Analysis. Nutrients 2023; 15:3225. [PMID: 37513644 PMCID: PMC10386542 DOI: 10.3390/nu15143225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Prenatal nutrition plays a crucial role in maternal and child health. This study aims to compare nutrient intake and its adequacy to recommendations among pregnant women in Spain and Poland. The ECLIPSES study in Spain utilized a self-administered food frequency questionnaire, while the PREDISH study in Poland employed a 3-day interview method. We assessed energy and nutrient intake against recommended dietary allowances. The analysis included 583 participants in the first trimester and 465 participants in the third trimester from both countries. Our findings revealed insufficient intake of iron, vitamin D, and vitamin B9 among pregnant women in both Spain and Poland. Significant differences were observed in the intake of energy, carbohydrates, fiber, calcium, iron, and vitamins D, E, C, B6, B9, and B12. Notably, 81.6% and 21.5% of participants did not meet the recommended minimum carbohydrate intake, while 99.8% and 43.8% exceeded the limit for total fat, particularly monounsaturated fatty acids (MUFAs). Tailored dietary guidance based on regional differences is crucial for pregnant women. Although variations in dietary intake were observed, both Spain and Poland faced similar risks of nutritional deficiencies, particularly for iron, vitamin D, and vitamin B9. These findings emphasize the need for enhanced efforts in preventing these deficiencies and promoting optimal prenatal nutrition.
Collapse
Affiliation(s)
- Lucía Iglesias-Vázquez
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, 43204 Reus, Spain
- Institut d'Investigació Sanitaria Pere Virgili (IISPV), 43204 Reus, Spain
| | - Joanna Suliburska
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, 60-637 Poznan, Poland
| | | | - Ewa Bakinowska
- Institute of Mathematics, Poznan University of Technology, 60-965 Poznan, Poland
| | - Victoria Arija
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, 43204 Reus, Spain
- Institut d'Investigació Sanitaria Pere Virgili (IISPV), 43204 Reus, Spain
- Collaborative Research Group on Lifestyles, Nutrition, and Smoking (CENIT), Tarragona-Reus Research Support Unit, IDIAP Jordi Gol, 43003 Tarragona, Spain
| |
Collapse
|
14
|
Ramachandra DS, Uppunda AK, Suryanarayana KG. Distortion product otoacoustic emissions in newborn babies with and without late-term maternal iron deficiency anaemia. J Otol 2023; 18:132-138. [PMID: 37497330 PMCID: PMC10366579 DOI: 10.1016/j.joto.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/05/2023] [Accepted: 05/22/2023] [Indexed: 07/28/2023] Open
Abstract
Background Studies on animals have demonstrated that maternal iron deficiency anaemia (IDA) could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions (DPOAEs) of young guinea pigs. Thus, it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA. The current study explores maternal IDA's effect on DPOAEs in newborn babies. Method A total of 110 newborn babies with gestational age ≥34 weeks were considered and a 'between-subjects' design was used. The participants were divided into 3 groups- "Normal" (61 babies without maternal IDA), "Mild" (28 babies with mild maternal IDA) and "Moderate" (21 babies with moderate maternal IDA). The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies (1 k - 8 kHz) and a range of intensities (70-40 dB SPL in 10 dB steps). Results The analysis of both DP-gram and DP input-output (I/O) function showed that there was no significant difference (p > 0.05) across the normal, mild, and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities (70-40 dB SPL). Also, the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship. Conclusion The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.
Collapse
Affiliation(s)
- Deepashree Somanahalli Ramachandra
- Vivekananda Memorial Hospital, A Unit of Swami Vivekananda Youth Movement (SVYM), Hanchipura Road, Saragur, Saragur Taluk, Mysuru District, Karnataka, 571121, India
- All India Institute of Speech and Hearing (AIISH), Manasagangothri, Mysuru, Karnataka, 570006, India
| | - Ajith Kumar Uppunda
- All India Institute of Speech and Hearing (AIISH), Manasagangothri, Mysuru, Karnataka, 570006, India
| | - Kumar Gavali Suryanarayana
- Vivekananda Memorial Hospital, A Unit of Swami Vivekananda Youth Movement (SVYM), Hanchipura Road, Saragur, Saragur Taluk, Mysuru District, Karnataka, 571121, India
| |
Collapse
|
15
|
Maternal factors associated with iron deficiency without anaemia in early pregnancy: ECLIPSES study. Ann Hematol 2023; 102:741-748. [PMID: 36790457 PMCID: PMC9998312 DOI: 10.1007/s00277-023-05123-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023]
Abstract
Several population-specific genetic, sociodemographic, and maternal lifestyle factors are related to iron status in early pregnancy, and their identification would allow preventive actions to be taken. The study aimed to identify maternal factors associated with iron deficiency (ID) in early pregnancy in non-anaemic pregnant women from a European Mediterranean country. Cross-sectional study using the initial population of the ECLIPSES study performed in non-anaemic pregnant women before gestational week 12. Serum ferritin (SF) and haemoglobin concentrations were measured to evaluate iron status, and ID was defined as SF < 15 µg/L. Several sociodemographic and lifestyle data were recorded and used as covariates in the multivariate-adjusted regression models. Out of the 791 participants, 13.9% had ID in early pregnancy. Underweight (OR 3.70, 95%CI 1.22, 15.53) and parity (1 child: OR 2.03, 95%CI 1.06, 3.88; ≥ 2 children: OR 6.96, 95%CI 3.09, 15.69) increased the odds of ID, while a high intake of total meat (≥ 108.57 g/day: OR 0.37, 95%CI 0.15, 0.87), red/processed meat (≥ 74.29 g/day: OR 0.70, 95%CI 0.35, 0.98), protein (≥ 65.05 g/day: OR 0.85, 95%CI 0.30, 0.99), and dietary iron (≥ 8.58 mg/day: OR 0.58, 95%CI 0.35, 0.94) protected against it. Smoking was also associated with a reduction in ID odds (OR 0.34, 95%CI 0.12, 0.99). Baseline BMI, parity, smoking, and diet are associated with ID in early pregnancy in non-anaemic women. Pregnancy planning policies should focus on women at higher risk of ID, such as those who are underweight, multiparous, or following vegetarian diets. This clinical trial was registered at www.clinicaltrialsregister.eu as EudraCT number 2012-005,480-28 and at www.clinicaltrials.gov with identification number NCT03196882.
Collapse
|
16
|
Koendjbiharie AP, Hindori-Mohangoo AD, Zijlmans WCWR, Wickliffe JK, Shankar A, Covert HH, Lichtveld MY, Grünberg AW, Drury SS. The Single and Combined Effects of Prenatal Nonchemical Stressors and Lead Exposure on Neurodevelopmental Outcomes in Toddlers: Results from the CCREOH Environmental Epidemiologic Study in Suriname. CHILDREN (BASEL, SWITZERLAND) 2023; 10:287. [PMID: 36832416 PMCID: PMC9954975 DOI: 10.3390/children10020287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
The primary aim of this prospective study was to examine the single and combined effect of prenatal exposure to perceived stress, probable depression, and lead on toddlers' neurodevelopment using the Bayley Scales of Infant and Toddler Development, third edition. Data from 363 mother-toddler pairs enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health prospective cohort study were analyzed. A prenatal lead exposure of ≥3.5 µg/dL was associated with significantly lower receptive (p = 0.008) and expressive (p = 0.006) communication scaled scores. Moderate and severe maternal prenatal probable depression scores were associated with significantly lower fine (p = 0.009) and gross (p = 0.009) motor scaled scores. However, a maternal report of prenatal stress was not associated with neurodevelopmental outcomes. After adjusting for maternal demographics, prenatal stress and lead exposure, prenatal probable depression remained predictive of the toddlers' gross motor scaled scores (β -0.13, 95% CI [-0.24--0.02]). Similarly, when adjusting for demographics, prenatal stress and probable depression, prenatal lead exposure remained a significant predictor of their receptive communication scaled scores (β -0.26, 95% CI [-0.49--0.02]). An analysis testing combined exposure to perceived stress, probable depression, and lead exposure, measured using a cumulative risk index, significantly predicted the child fine motor scaled scores after adjusting for other covariates (β -0.74, 95% CI: [-1.41--0.01]).
Collapse
Affiliation(s)
- Aloysius Ph. Koendjbiharie
- Community Health Department, Regional Health Services, Paramaribo, Suriname
- Faculty of Medical Science, Anton De Kom University, Paramaribo, Suriname
| | - Ashna D. Hindori-Mohangoo
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Wilco C. W. R. Zijlmans
- Faculty of Medical Science, Anton De Kom University, Paramaribo, Suriname
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Jeffrey K. Wickliffe
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Arti Shankar
- Department of Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Hannah H. Covert
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Department of Environmental and Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Maureen Y. Lichtveld
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Department of Environmental and Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Antoon W. Grünberg
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - Stacy S. Drury
- Department of Psychiatry, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| |
Collapse
|
17
|
Zhu Z, Zhu Y, Wang L, Qi Q, Huang L, Andegiorgish AK, Elhoumed M, Cheng Y, Dibley MJ, Sudfeld CR, Zeng L. Effects of antenatal micronutrient supplementation regimens on adolescent emotional and behavioral problems: A 14-year follow-up of a double-blind, cluster-randomized controlled trial. Clin Nutr 2023; 42:129-135. [PMID: 36527827 DOI: 10.1016/j.clnu.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/14/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Antenatal multiple micronutrient supplementation has been shown to have beneficial effects on birth outcomes and may improve child development. However, whether there is an effect of antenatal micronutrient supplementation strategies on offspring socioemotional outcomes remains unknown. We aimed to examine the effect of antenatal folic acid (FA), iron-folic acid (IFA), and multiple micronutrient (MMN) supplementation on adolescent emotional and behavioral outcomes. METHODS We conducted a double-blind, cluster-randomized trial of antenatal micronutrient supplementation in rural western China between 2002 and 2006. Pregnant females were randomized by village to receive either daily (i) 400 μg FA, (ii) IFA containing 60 mg iron and 400 μg FA or (iii) MMN supplementation containing 30 mg iron, 400 μg FA plus 13 additional vitamins and minerals. A 14-year follow-up of their offspring was conducted in 2016. Adolescents were administered the locally adapted Youth Self-Report-2001 (YSR-2001) which produced internalizing, externalizing, and total behavior problem scores. We applied generalized estimating equations to assess the effect of the randomized regimens on YSR-2001 scores and explored the potential effect modification by household wealth and initial timing and duration of supplementation. RESULTS A total of 1920 adolescents were included in the analysis, 1130 (58.9%) were male, and the mean (SD) age was 11.8 (0.78) years. Adolescents in IFA group had lower total (mean difference (MD): -2.89; 95% CI -5.73, -0.04) and externalizing (MD: -0.97; 95% CI -1.79, -0.15) problem scores as compared to those in FA group. There was no effect of MMN on behavior problem scores as compared to IFA and FA alone. Although, in effect modification analyses, MMN appeared to have greater beneficial effects in wealthier households than IFA and FA alone. CONCLUSIONS Iron supplementation during pregnancy reduced adolescent emotional and behavioral problem scores which provides additional support for expanding coverage of iron-containing prenatal supplements in resource-limited settings. TRIAL REGISTRATION isrctn. org Identifier: ISRCTN08850194.
Collapse
Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Yingze Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Liang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Qi Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Lin Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Amanuel Kidane Andegiorgish
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Michael J Dibley
- The Sydney School of Public Health, Faculty of Medicine, The University of Sydney, NSW, Australia
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi, PR China.
| |
Collapse
|
18
|
Shi Y, Zhang J, Luo K, Pan S, Shi H, Xiong L, Du S. The Roles of Iron and Ferroptosis in Human Chronic Diseases. Biochemistry 2023. [DOI: 10.5772/intechopen.108790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Ferroptosis, an iron-dependent novel type of cell death, has been characterized as an excessive accumulation of lipid peroxides and reactive oxygen species. A growing number of studies demonstrate that ferroptosis not only plays an important role in the pathogenesis and progression of chronic diseases, but also functions differently in different diseases. As a double-edged sword, activation of ferroptosis could potently inhibit tumor growth and increase sensitivity to chemotherapy and immunotherapy in various cancer settings. Therefore, the development of more efficacious ferroptosis agonists or inhibitors remains the mainstay of ferroptosis-targeting strategy for cancer therapeutics or cardiovascular and cerebrovascular diseases and neurodegenerative diseases therapeutics.
Collapse
|
19
|
Prevalence and Implications of Low Reticulocyte-Hemoglobin Levels among Extreme Preterm Neonates: A Single-Center Retrospective Study. Nutrients 2022; 14:nu14245343. [PMID: 36558502 PMCID: PMC9788547 DOI: 10.3390/nu14245343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/29/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
This retrospective cohort study aims to determine the epidemiology of iron deficiency among extreme preterm neonates and the association of iron-deficient status during the NICU stay with neurodevelopmental outcomes at 18−24 months. Neonates ≤29 weeks gestational age (GA) born between June 2016 and December 2019, who received routine iron supplementation were enrolled. Iron deficiency was defined as reticulocyte−hemoglobin (Ret-Hb) levels ≤ 29 pg at 36 weeks corrected age. A subcohort of neonates completed standardized developmental assessment at 18−24 months corrected age. Significant neurodevelopmental impairment (sNDI) was defined as either Bayley Scales of Infant Development score < 70 or cerebral palsy or blindness or hearing aided. Among a cohort of 215 neonates [GA 25.8 (1.7) weeks, birthweight 885 (232) g], prevalence of iron deficiency was 55%, 21%, 26%, and 13%, in neonates <24 weeks, 24−25 + 6 weeks, 26−27 + 6 weeks, and ≥ 28 weeks GA, respectively. Male sex and receipt of corticosteroid therapy were associated with iron-deficiency. In the subcohort analysis (n = 69), there was no statistically significant association between Ret-Hb levels at 36 weeks corrected age and the risk of sNDI [OR 0.99 (95% CI 0.85−1.2)]. Male infants and those who received postnatal corticosteroids are likely to have iron-limited erythropoiesis at corrected term despite routine iron-supplementation; however, low Ret-Hb levels during the neonatal period were not associated with significant neurological disability in early childhood.
Collapse
|
20
|
Effect of Oral Iron Supplementation on Cognitive Function among Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14245332. [PMID: 36558491 PMCID: PMC9783508 DOI: 10.3390/nu14245332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is abundant evidence showing that iron deficiency is closely linked with delayed brain development, worse school performance, and behavioral abnormalities. However, evidence on the impact of iron supplementation among children and adolescents in low- and middle-income countries (LMICs) has been inconsistent. This study aims to examine the effect of oral iron supplementation on cognitive function among children and adolescents in LMICs. METHODS A systematic review and meta-analysis was conducted to examine the impact of iron supplementation on cognitive function (including intelligence, attention, short-term memory, long-term memory, and school performance) among children and adolescents aged 5 to 19. We searched PubMed, Embase, Web of Science, CINAHL, and references of related articles published from the inception of the databases to 1 May 2022. Random-effects pooled standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated to estimate the effect of iron supplementation on cognitive function. We also investigated the heterogeneity of the effects using subgroup and meta-regression analyses. This review was registered with PROSPERO (CRD42020179064). RESULTS Nine studies with 1196 individual participants from five countries were identified and included. Iron had a positive impact on intelligence test scores among children and adolescents (SMD = 0.47, 95% confidence interval [CI]: 0.10, 0.83). Meta-regression showed that the intelligence test scores improved with increasing the iron supplement dose (odds ratio [CI] = 1.02, 95% CI: 1.00, 1.04). There were no significant effects on attention, short-term memory, long-term memory, or school performance. CONCLUSIONS Oral iron intake can improve the intelligence test scores of children and adolescents in LMICs and should be considered for future nutritional interventions.
Collapse
|
21
|
Mukwevho T, Smuts CM, Asare H, Faber M. Energy and nutrient contribution of different food groups to the dietary intake of 6- to <9-month-old infants in a low socioeconomic community in North West Province, South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2141051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Tshiphiri Mukwevho
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa
| | - Hannah Asare
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa
| | - Mieke Faber
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
| |
Collapse
|
22
|
Wedderburn CJ, Ringshaw JE, Donald KA, Joshi SH, Subramoney S, Fouche JP, Stadler JAM, Barnett W, Rehman AM, Hoffman N, Roos A, Narr KL, Zar HJ, Stein DJ. Association of Maternal and Child Anemia With Brain Structure in Early Life in South Africa. JAMA Netw Open 2022; 5:e2244772. [PMID: 36459137 PMCID: PMC9719049 DOI: 10.1001/jamanetworkopen.2022.44772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/18/2022] [Indexed: 12/03/2022] Open
Abstract
Importance Anemia affects millions of pregnant women and their children worldwide, particularly in low- and middle-income countries. Although anemia in pregnancy is a well-described risk factor for cognitive development, the association with child brain structure is poorly understood. Objective To explore the association of anemia during pregnancy and postnatal child anemia with brain structure in early life. Design, Setting, and Participants This neuroimaging nested cohort study was embedded within the Drakenstein Child Health Study (DCHS), a population-based birth cohort in South Africa. Pregnant individuals were enrolled into the DCHS between 2012 and 2015 from 2 clinics in a periurban setting. Mother-child pairs were assessed prospectively; follow-up is ongoing. A subgroup of children had brain magnetic resonance imaging (MRI) at age 2 to 3 years from 2015 to 2018. This study focused on the 147 pairs with structural neuroimaging and available hemoglobin data. Data analyses were conducted in 2021 and 2022. Exposures Mothers had hemoglobin measurements during pregnancy, and a subgroup of children had hemoglobin measurements during early life. Anemia was classified as hemoglobin levels less than 11 g/dL based on World Health Organization guidelines; children younger than 6 months were classified using local guidelines. Main Outcomes and Measures Child brain volumes of global, subcortical, and corpus callosum structures were quantified using T1-weighted MRI. Linear regression models were used to analyze the associations between maternal and child anemia with child brain volumes, accounting for potential confounders. Results Of 147 children (mean [SD] age at MRI, 34 [2] months; 83 [56.5%] male) with high-resolution MRI scans, prevalence of maternal anemia in pregnancy was 31.3% (46 of 147; median [IQR] gestation of measurement: 13 [9-20] weeks). Maternal anemia during pregnancy was significantly associated with smaller volumes of the child caudate bilaterally (adjusted percentage difference, -5.30% [95% CI, -7.01 to -3.59]), putamen (left hemisphere: -4.33% [95% CI, -5.74 to -2.92]), and corpus callosum (-7.75% [95% CI, -11.24 to -4.26]). Furthermore, antenatal maternal hemoglobin levels were also associated with brain volumes in the caudate (left hemisphere: standardized β = 0.15 [95% CI, 0.02 to 0.28]; right hemisphere: β = 0.15 [95% CI, 0.02 to 0.27]), putamen left hemisphere (β = 0.21 [95% CI, 0.07 to 0.35]), and corpus callosum (β = 0.24 [95% CI, 0.09 to 0.39]). Prevalence of child anemia was 52.5% (42 of 80; median [IQR] age of measurement: 8.0 [2.7 to 14.8] months). Child anemia was not associated with brain volumes, nor did it mediate the association of maternal anemia during pregnancy with brain volumes. Conclusions and Relevance In this cohort study, anemia in pregnancy was associated with altered child brain structural development. Given the high prevalence of antenatal maternal anemia worldwide, these findings suggest that optimizing interventions during pregnancy may improve child brain outcomes.
Collapse
Affiliation(s)
- Catherine J. Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jessica E. Ringshaw
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Shantanu H. Joshi
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
- Department of Bioengineering, University of California, Los Angeles
| | - Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Jean-Paul Fouche
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jacob A. M. Stadler
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Andrea M. Rehman
- MRC International Statistics & Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nadia Hoffman
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - Annerine Roos
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Katherine L. Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
23
|
Díaz-López A, Sans JC, Julvez J, Fernandez-Bares S, Llop S, Rebagliato M, Lertxundi N, Santa-Marina L, Guxens M, Sunyer J, Arija V. Maternal iron status during pregnancy and attention deficit/hyperactivity disorder symptoms in 7-year-old children: a prospective cohort study. Sci Rep 2022; 12:20762. [PMID: 36456588 PMCID: PMC9715623 DOI: 10.1038/s41598-022-23432-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 10/31/2022] [Indexed: 12/04/2022] Open
Abstract
Evidence suggests that iron status may be linked to symptoms of childhood attention deficit/hyperactivity disorder (ADHD), but there is little data available on the relationship between iron status in pregnancy and the risk of developing ADHD. And the data that does exist is inconsistent. Our aim here is to assess the effect of maternal serum ferritin (SF) and haemoglobin (Hb) levels during pregnancy on manifestations of ADHD in children at 7 years of age. This prospective study analysed data from 1204 mother-child pairs from three Spanish cohorts participating in the INMA project. Maternal SF and Hb levels during pregnancy and other mother and child characteristics were collected. The children's ADHD behaviours were reported by their parents using Conners' Parent Rating Scale-Revised Short Form (CPRS-R:S). In the unadjusted regression analysis, maternal SF was positively associated with children's T-scores on the subscales Cognitive problems/Inattention (β: 0.63, 95%CI 0.06-1.19; p = 0.029) and ADHD index (β: 0.72, 95%CI 0.20-1.24; p = 0.007). These associations were not present after multivariate adjustment or stratification by first and second trimester of pregnancy. The Hb levels were not related to any of the CPRS-R:S subscales in unadjusted or multivariate-adjusted models. We observed no association between maternal SF or Hb levels and the risk of ADHD symptomatology (T-score ≥ 65 for CPRS-R:S subscales). Our results suggest that neither maternal SF nor Hb levels during pregnancy are related to ADHD symptoms in 7-year-old children.
Collapse
Affiliation(s)
- Andrés Díaz-López
- grid.410367.70000 0001 2284 9230Department of Basic Medical Sciences, Nutrition and Mental Health Research Group (NUTRISAM), Rovira I Virgili University (URV), C/ Sant Llorenç 21, 43201 Reus, Tarragona Spain ,grid.420268.a0000 0004 4904 3503Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - Josefa Canals Sans
- grid.410367.70000 0001 2284 9230Department of Basic Medical Sciences, Nutrition and Mental Health Research Group (NUTRISAM), Rovira I Virgili University (URV), C/ Sant Llorenç 21, 43201 Reus, Tarragona Spain ,grid.420268.a0000 0004 4904 3503Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain ,grid.410367.70000 0001 2284 9230Research Center for Behavioral Assessment (CRAMC), Rovira I Virgili University (URV), Tarragona, Spain
| | - Jordi Julvez
- grid.420268.a0000 0004 4904 3503Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain ,grid.434607.20000 0004 1763 3517Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Silvia Fernandez-Bares
- grid.434607.20000 0004 1763 3517Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Sabrina Llop
- grid.5338.d0000 0001 2173 938XEpidemiology and Environmental Health Joint Research Unit, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain ,grid.413448.e0000 0000 9314 1427Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marisa Rebagliato
- grid.5338.d0000 0001 2173 938XEpidemiology and Environmental Health Joint Research Unit, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain ,grid.413448.e0000 0000 9314 1427Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Nerea Lertxundi
- grid.413448.e0000 0000 9314 1427Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain ,grid.432380.eBiodonostia, Epidemiology and Public Health Area, Environmental Epidemiology and Child Development Group, San Sebastian, Spain ,grid.11480.3c0000000121671098Faculty of Psychology, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Loreto Santa-Marina
- grid.413448.e0000 0000 9314 1427Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain ,grid.432380.eBiodonostia, Epidemiology and Public Health Area, Environmental Epidemiology and Child Development Group, San Sebastian, Spain ,grid.11480.3c0000000121671098Faculty of Psychology, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Mònica Guxens
- grid.434607.20000 0004 1763 3517Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain ,grid.5612.00000 0001 2172 2676Pompeu Fabra University, Barcelona, Spain ,grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Jordi Sunyer
- grid.434607.20000 0004 1763 3517Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain ,grid.5612.00000 0001 2172 2676Pompeu Fabra University, Barcelona, Spain
| | - Victoria Arija
- grid.410367.70000 0001 2284 9230Department of Basic Medical Sciences, Nutrition and Mental Health Research Group (NUTRISAM), Rovira I Virgili University (URV), C/ Sant Llorenç 21, 43201 Reus, Tarragona Spain ,grid.420268.a0000 0004 4904 3503Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| |
Collapse
|
24
|
Heland S, Fields N, Ellery SJ, Fahey M, Palmer KR. The role of nutrients in human neurodevelopment and their potential to prevent neurodevelopmental adversity. Front Nutr 2022; 9:992120. [PMID: 36483929 PMCID: PMC9722743 DOI: 10.3389/fnut.2022.992120] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/02/2022] [Indexed: 06/21/2024] Open
Abstract
Nutritional deficits or excesses affect a huge proportion of pregnant women worldwide. Maternal nutrition has a significant influence on the fetal environment and can dramatically impact fetal brain development. This paper reviews current nutritional supplements that can be used to optimise fetal neurodevelopment and prevent neurodevelopmental morbidities, including folate, iodine, vitamin B12, iron, and vitamin D. Interestingly, while correcting nutritional deficits can prevent neurodevelopmental adversity, overcorrecting them can in some cases be detrimental, so care needs to be taken when recommending supplementation in pregnancy. The potential benefits of using nutrition to prevent neurodiversity is shown by promising nutraceuticals, sulforaphane and creatine, both currently under investigation. They have the potential to promote improved neurodevelopmental outcomes through mitigation of pathological processes, including hypoxia, inflammation, and oxidative stress. Neurodevelopment is a complex process and whilst the role of micronutrients and macronutrients on the developing fetal brain is not completely understood, this review highlights the key findings thus far.
Collapse
Affiliation(s)
- Sarah Heland
- Monash Women’s and Newborn, Monash Health, Clayton, VIC, Australia
| | - Neville Fields
- Monash Women’s and Newborn, Monash Health, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Stacey Joan Ellery
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Michael Fahey
- Paediatric Neurology Unit, Monash Children’s Hospital, Clayton, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Kirsten Rebecca Palmer
- Monash Women’s and Newborn, Monash Health, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| |
Collapse
|
25
|
Bradley R, Lakpa KL, Burd M, Mehta S, Katusic MZ, Greenmyer JR. Fetal Alcohol Spectrum Disorder and Iron Homeostasis. Nutrients 2022; 14:4223. [PMID: 36296909 PMCID: PMC9607572 DOI: 10.3390/nu14204223] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 09/19/2023] Open
Abstract
Prenatal alcohol exposure results in a spectrum of behavioral, cognitive, and morphological abnormalities collectively referred to as fetal alcohol spectrum disorder (FASD). FASD presents with significant phenotypic variability and may be modified by gestational variables such as maternal nutritional status. Iron serves a critical function in the development of and processes within central nervous system (CNS) structures. Gestational iron deficiency alters CNS development and may contribute to neurodevelopmental impairment in FASD. This review explores the relationship between iron deficiency and fetal alcohol spectrum disorder as described in small animal and human studies. Consideration is given to the pathophysiologic mechanisms linking iron homeostasis and prenatal alcohol exposure. Existing data suggest that iron deficiency contributes to the severity of FASD and provide a mechanistic explanation linking these two conditions.
Collapse
Affiliation(s)
- Regan Bradley
- School of Medicine, University of North Dakota, Grand Forks, ND 58201, USA
| | - Koffi L. Lakpa
- School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA
| | - Michael Burd
- School of Medicine, University of North Dakota, Grand Forks, ND 58201, USA
| | - Sunil Mehta
- Mayo Clinic, Developmental and Behavioral Pediatrics, Psychiatry and Psychology, Rochester, MN 55905, USA
| | - Maja Z. Katusic
- Mayo Clinic, Pediatric and Adolescent Medicine, Rochester, MN 55905, USA
| | - Jacob R. Greenmyer
- Mayo Clinic, Pediatric and Adolescent Medicine, Rochester, MN 55905, USA
| |
Collapse
|
26
|
de Lauzon-Guillain B, Marques C, Kadawathagedara M, Bernard JY, Tafflet M, Lioret S, Charles MA. Maternal diet during pregnancy and child neurodevelopment up to age 3.5 years: the nationwide Étude Longitudinale Française depuis l'Enfance (ELFE) birth cohort. Am J Clin Nutr 2022; 116:1101-1111. [PMID: 35918250 DOI: 10.1093/ajcn/nqac206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/26/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Dietary guidelines available to pregnant women are made to improve maternal health and fetal development. But their adequacy to sustain offspring neurodevelopment has remained understudied. OBJECTIVES We assessed the association between compliance with nutritional guidelines during pregnancy and neurodevelopment in preschool children. METHODS The analyses were based on data for 6780 to 11,278 children from the Étude Longitudinale Française depuis l'Enfance (ELFE) study, a nationwide birth cohort. Maternal diet during the last 3 mo of pregnancy was evaluated at delivery by using a validated 125-item FFQ. From this FFQ, food group consumption, a diet quality score (adapted National Health and Nutrition Program Guideline Score), and a nutrient intake score (Probability of Adequate Nutrient intake based Diet quality index) were calculated and dietary patterns were derived by principal component analysis. Child neurodevelopment was reported by parents at 1 and 3.5 y with the Child Development Inventory (CDI-1, CDI-3.5) and at 2 y with the MacArthur-Bates Communicative Development Inventories (MB-2), and assessed by a trained investigator at 3.5 y with the Picture Similarities test (British Ability Scales, PS-3.5). Associations between maternal diet and child neurodevelopment were assessed by multivariable linear regression models on standardized variables. RESULTS Higher nutrient intake score was associated with higher neurodevelopmental scores from 1 to 3.5 y (β = 0.04; 95% CI: 0.02, 0.06 for CDI-1; β = 0.03; 95% CI: 0.01, 0.05 for MB-2; and β = 0.03; 95% CI: 0.01, 0.05 for CDI-3.5). Higher fruit and vegetables or fish intake and lower pork-meat products intake were related to higher CDI-3.5 scores (β = 0.03; 95% CI: 0.01, 0.05 for fruit and vegetables; β = 0.03; 95% CI: 0.01, 0.05 for fish; and β = -0.02; 95% CI: -0.04, 0.00 for pork-meat products). A higher score on the processed food pattern was associated with poorer neurodevelopmental score at 1 y (β = -0.05; 95% CI: -0.06, -0.03). CONCLUSIONS Higher diet quality during pregnancy was associated with higher parent-reported neurodevelopmental scores in early childhood. The negative association of pork-meat products consumption with early neurodevelopmental scores needs to be further confirmed.
Collapse
Affiliation(s)
| | - Chloé Marques
- Université Paris Cité, CRESS, Inserm, INRAE, Paris, France
| | | | - Jonathan Y Bernard
- Université Paris Cité, CRESS, Inserm, INRAE, Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Muriel Tafflet
- Université Paris Cité, CRESS, Inserm, INRAE, Paris, France
| | | | - Marie Aline Charles
- Université Paris Cité, CRESS, Inserm, INRAE, Paris, France.,Unité mixte Inserm-Ined-EFS ELFE, Ined, Aubervilliers, France
| |
Collapse
|
27
|
Abbas M, Hayirli Z, Drakesmith H, Andrews SC, Lewis MC. Effects of iron deficiency and iron supplementation at the host-microbiota interface: Could a piglet model unravel complexities of the underlying mechanisms? Front Nutr 2022; 9:927754. [PMID: 36267902 PMCID: PMC9577221 DOI: 10.3389/fnut.2022.927754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/05/2022] [Indexed: 01/14/2023] Open
Abstract
Iron deficiency is the most prevalent human micronutrient deficiency, disrupting the physiological development of millions of infants and children. Oral iron supplementation is used to address iron-deficiency anemia and reduce associated stunting but can promote infection risk since restriction of iron availability serves as an innate immune mechanism against invading pathogens. Raised iron availability is associated with an increase in enteric pathogens, especially Enterobacteriaceae species, accompanied by reductions in beneficial bacteria such as Bifidobacteria and lactobacilli and may skew the pattern of gut microbiota development. Since the gut microbiota is the primary driver of immune development, deviations from normal patterns of bacterial succession in early life can have long-term implications for immune functionality. There is a paucity of knowledge regarding how both iron deficiency and luminal iron availability affect gut microbiota development, or the subsequent impact on immunity, which are likely to be contributors to the increased risk of infection. Piglets are naturally iron deficient. This is largely due to their low iron endowments at birth (primarily due to large litter sizes), and their rapid growth combined with the low iron levels in sow milk. Thus, piglets consistently become iron deficient within days of birth which rapidly progresses to anemia in the absence of iron supplementation. Moreover, like humans, pigs are omnivorous and share many characteristics of human gut physiology, microbiota and immunity. In addition, their precocial nature permits early maternal separation, individual housing, and tight control of nutritional intake. Here, we highlight the advantages of piglets as valuable and highly relevant models for human infants in promoting understanding of how early iron status impacts physiological development. We also indicate how piglets offer potential to unravel the complexities of microbiota-immune responses during iron deficiency and in response to iron supplementation, and the link between these and increased risk of infectious disease.
Collapse
Affiliation(s)
- Munawar Abbas
- Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | - Zeynep Hayirli
- Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | - Hal Drakesmith
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Simon C. Andrews
- School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Marie C. Lewis
- Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| |
Collapse
|
28
|
Nakhid D, McMorris C, Sun H, Gibbard WB, Tortorelli C, Lebel C. Brain volume and magnetic susceptibility differences in children and adolescents with prenatal alcohol exposure. Alcohol Clin Exp Res 2022; 46:1797-1807. [PMID: 36016464 DOI: 10.1111/acer.14928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) can negatively affect brain development thereby increasing the risk of cognitive deficits, behavioral challenges, and mental health problems. Brain iron is important for a number of physiological processes for healthy brain development. Animal studies show that PAE reduced brain iron; however, this has not been investigated in human children with PAE. METHODS We studied 20 children and adolescents with PAE and 44 unexposed children and adolescents aged 7.5 to 15 years. All children underwent quantitative susceptibility mapping and T1-weighted magnetic resonance imaging scans. Susceptibility and volume measurements of the caudate, putamen, pallidum, thalamus, amygdala, hippocampus, and nucleus accumbens were extracted using FreeSurfer. ANCOVAs were used to compare volume and susceptibility between groups for each region of interest, controlling for age and gender. For structures where susceptibility differed by group, we also tested for an association between intelligence quotient (IQ) and susceptibility. RESULTS There were no significant group differences in susceptibility after multiple comparison correction, though the PAE group had higher susceptibility in the thalamus compared to unexposed participants before correction (p = 0.032, q = 0.230). There was no association between IQ and thalamus susceptibility. The PAE group had significantly lower volume in the bilateral caudate, bilateral pallidum, and left putamen. CONCLUSIONS These findings suggest susceptibility may be altered in children and adolescents with PAE, though more research is needed. Volume reductions are consistent with previous literature and likely underlie cognitive and behavioral deficits associated with PAE.
Collapse
Affiliation(s)
- Daphne Nakhid
- Department of Neuroscience, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carly McMorris
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,School and Applied Child Psychology, Werklund School of Education, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Hongfu Sun
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Queensland, Australia
| | - William Benton Gibbard
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Christina Tortorelli
- Department of Child Studies and Social Work, Mount Royal University, Calgary, Alberta, Canada
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
29
|
Iglesias-Vázquez L, Hernández-Martínez C, Voltas N, Canals J, Coronel P, Gimeno M, Arija V. Adapting prenatal iron supplementation to maternal needs results in optimal child neurodevelopment: a follow-up of the ECLIPSES Study. BMC Pregnancy Childbirth 2022; 22:710. [PMID: 36115950 PMCID: PMC9482254 DOI: 10.1186/s12884-022-05033-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Prenatal prescription of standard iron supplements to prevent iron deficiency appears not to be appropriate for all women and their children, as some women may be at risk of iron deficiency and others at risk of iron excess early in pregnancy. The present study aimed to assess whether prenatal iron supplementation adapted to the needs of each pregnant woman affects their child’s neurodevelopment.
Methods
Follow-up of a community-based RCT involving 503 mother–child pairs. Non-anaemic pregnant women recruited in Tarragona (Spain) early in pregnancy were prescribed a daily iron dose based on their initial haemoglobin levels: Stratum 1 (Hb = 110–130 g/L, 80 or 40 mg/d of iron) and Stratum 2 (Hb > 130 g/L, 40 or 20 mg/d of iron). Women receiving 40 mg/d were considered the control group in each Strata. The child’s neurodevelopment was assessed at 40 days of age using the Bayley Scales of Infant Development-III (BSID-III). Adjusted multiple regression models were used.
Results
Multiple regression analyses showed no association between the intervention and control group within each Strata on the BSID-III scores on any of the developmental scales in children, including cognitive, language, and motor development: Stratum 1 (β 1.46, 95%CI -2.15, 5.07; β 1.30, 95%CI -1.99, 4.59; and β 2.04, 95%CI -3.88, 7.96, respectively) and Stratum 2 (β -4.04, 95%CI -7.27, 0.80; β -0.36, 95%CI -3.47, 2.75; and β -3.76, 95%CI -9.30, 1.78, respectively).
Conclusions
In non-anaemic women in early pregnancy, no differences were found in the cognitive, language and motor development of children at 40 days of age between the dose of iron tested in each case –adjusted to initial Hb levels– compared to the dose of the control group. Further studies are guaranteed to confirm our findings.
Trial registration
The ECLIPSES study was registered at www.clinicaltrialsregister.eu as EudraCT number 2012–005,480-28.
Collapse
|
30
|
Taddesse E, Alemu DG, Haider MR, Haile ZT. Association between receipt of nutritional counseling during antenatal care visits and anemia: A cross-sectional study. J Hum Nutr Diet 2022; 36:763-771. [PMID: 36076308 DOI: 10.1111/jhn.13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/30/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Anemia during pregnancy is associated with premature births, low birth weight and increased susceptibility to infection. Nearly a quarter (24.34%) of Ethiopian pregnant women suffer from anemia. Nutritional counseling during antenatal care (ANC) visits may encourage pregnant women to take a more iron-rich diet and prevent anemia. This study examines the association between nutritional counseling during ANC and anemia among Ethiopian women. METHODS This cross-sectional study uses the 2016 Ethiopia Demographic and Health Survey (EDHS) data (n=4, 384). The outcome of interest was anemia, measured objectively by blood hemoglobin level. The main independent variable was the receipt of nutritional counseling during ANC visits. Univariate, bivariate, and multivariable analyses were performed using SAS 9.4. RESULTS Overall, 25.8% of the participants were anemic and 65.7% received nutritional counseling during ANC visits. Compared to women who received nutritional counseling during ANC visits, a significantly higher proportion of women who did not receive nutritional counseling were anemic (23.1% vs. 30.8%; p<0.001). In the multivariable model, compared to women who received nutritional counseling during their ANC visits, the odds of being anemic were higher among women who did not receive nutritional counseling during their ANC visits AOR 1.34 (95% CI) = (1.07-1.67; p=0.010). CONCLUSION In a representative sample of Ethiopian women, exposure to nutritional counseling during ANC visits is associated with a lower likelihood of anemia, independent of potential confounders. Focused ANC counseling that includes nutritional counseling programs during ANC visits can be an effective strategy to prevent and control anemia. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Eden Taddesse
- Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
| | - Dawit G Alemu
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Mohammad R Haider
- Department of Health Policy and Management, University of Georgia, Athens, GA, USA
| | - Zelalem T Haile
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
| |
Collapse
|
31
|
Iron Metabolism and Ferroptosis in Physiological and Pathological Pregnancy. Int J Mol Sci 2022; 23:ijms23169395. [PMID: 36012659 PMCID: PMC9409111 DOI: 10.3390/ijms23169395] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 12/13/2022] Open
Abstract
Iron is a vital element in nearly every living organism. During pregnancy, optimal iron concentration is essential for both maternal health and fetal development. As the barrier between the mother and fetus, placenta plays a pivotal role in mediating and regulating iron transport. Imbalances in iron metabolism correlate with severe adverse pregnancy outcomes. Like most other nutrients, iron exhibits a U-shaped risk curve. Apart from iron deficiency, iron overload is also dangerous since labile iron can generate reactive oxygen species, which leads to oxidative stress and activates ferroptosis. In this review, we summarized the molecular mechanism and regulation signals of placental iron trafficking under physiological conditions. In addition, we revealed the role of iron metabolism and ferroptosis in the view of preeclampsia and gestational diabetes mellitus, which may bring new insight to the pathogenesis and treatment of pregnancy-related diseases.
Collapse
|
32
|
Kadim IT, Al-Amri IS, Alkindi AY, Haq QMI. Nutritional values and health benefits of dromedary camel meat. Anim Front 2022; 12:61-70. [PMID: 35974788 PMCID: PMC9374515 DOI: 10.1093/af/vfac051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Isam T Kadim
- Department of Biological Sciences and Chemistry, College of Arts and Sciences, University of Nizwa, PO Box 33, PC 616, Birkat Al-Mouz, Nizwa, Sultanate of Oman
| | - Issa S Al-Amri
- Department of Biological Sciences and Chemistry, College of Arts and Sciences, University of Nizwa, PO Box 33, PC 616, Birkat Al-Mouz, Nizwa, Sultanate of Oman
| | - Abdulaziz Y Alkindi
- Department of Biological Sciences and Chemistry, College of Arts and Sciences, University of Nizwa, PO Box 33, PC 616, Birkat Al-Mouz, Nizwa, Sultanate of Oman
| | - Quazi M I Haq
- Department of Biological Sciences and Chemistry, College of Arts and Sciences, University of Nizwa, PO Box 33, PC 616, Birkat Al-Mouz, Nizwa, Sultanate of Oman
| |
Collapse
|
33
|
Cecilia A, Patricio P, Donna C, Rakibul H, Sussanne R, Betsy L, Bharat B. Cognitive control inhibition networks in adulthood are impaired by early iron deficiency in infancy. Neuroimage Clin 2022; 35:103089. [PMID: 35753235 PMCID: PMC9249946 DOI: 10.1016/j.nicl.2022.103089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/26/2022]
Abstract
Iron deficiency, a common form of micronutrient deficiency, primarily affects children and women. The principal cause of iron deficiency is undernutrition in low-income countries and malnutrition in middle to upper income regions. Iron is a key element for myelin production, neuronal metabolism, and dopamine functions. Iron deficiency in early life can alter brain development and exert long-lasting effects. Control inhibition is an executive function that involves several brain regions, including the prefrontal cortex and caudate and sub-thalamic nuclei. Dopamine is the prevalent neurotransmitter underlying cognitive inhibition. We followed cohort study participants who had iron deficiency anemia in infancy as well non-anemic controls. At 22 years of age, the participants were subjected to functional magnetic resonance imaging (fMRI) to evaluate the correlation between functional connectivity and performance on an inhibitory cognitive task (Go/No-Go). We hypothesized that former iron deficient anemic (FIDA) participants demonstrate less strength in functional connectivity compared with controls (C). There were not significant group differences in the behavioral results in terms of accuracy and response time. A continuous covariate interaction analysis of functional connectivity and the Go/No-Go scores demonstrated significant differences between the FIDA and C groups. The FIDA participants demonstrated less strength in connectivity in brain regions related to control inhibition, including the medial temporal lobe, impairment in the integration of the default mode network (indicating decreased attention and alertness), and an increase in connectivity in posterior brain areas, all of which suggest slower circuitry maturation. The results support the hypothesis that FIDA young adults show differences in the connectivity of networks related to executive functions. These differences could increase their vulnerability to develop cognitive dysfunctions or mental disorders in adulthood.
Collapse
Affiliation(s)
- Algarín Cecilia
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile,Corresponding author at: El Líbano 5524, Macul 7830490, Región Metropolitana, Santiago, Chile.
| | - Peirano Patricio
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile
| | - Chen Donna
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
| | - Hafiz Rakibul
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
| | - Reyes Sussanne
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile
| | - Lozoff Betsy
- Department of Pediatrics and Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Biswal Bharat
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
| |
Collapse
|
34
|
Noel SC, Fortin-Hamel L, Haque M, Scott ME. Maternal gastrointestinal nematode infection enhances spatial memory of uninfected juvenile mouse pups. Sci Rep 2022; 12:9796. [PMID: 35697723 PMCID: PMC9192650 DOI: 10.1038/s41598-022-13971-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/31/2022] [Indexed: 11/17/2022] Open
Abstract
The developing brain is particularly vulnerable to factors including maternal infection during pregnancy. Establishment of neural networks critical for memory and cognition begins during the perinatal period, when Heligmosomoides bakeri, a gastrointestinal (GI) nematode restricted to the maternal mouse intestine, has been shown to upregulate expression of long-term potentiation genes in the young rodent pup brain. We explored the impact of maternal infection during pregnancy and early lactation on the spatial behavior of uninfected male and female juvenile mice. Pre-weaned pups of H. bakeri infected dams exhibited less exploratory behaviour compared to pups of uninfected dams on postnatal day (PD) 16 but not PD 17, possibly reflecting a transient fear of an unfamiliar environment and/or a brief neurodevelopmental delay. Our two spatial memory tests show for the first time an enhancement of spatial memory in response to maternal nematode infection regardless of pup sex. At PD 17, pups of infected dams expressed object location memories after 3 h in the Object Location Test whereas offspring of uninfected mothers did not. In addition, at PD 34, juveniles of infected mothers retained their ability to find the escape hole in the Barnes Maze Test for one week whereas offspring from uninfected mothers did not. This finding is even more striking given that spatial memory was positively associated with pup length, yet this maternal infection impaired linear growth of pups. Thus, the positive impact of maternal infection on spatial memory countered any impairment associated with the shorter length of the pups. Overall, these novel findings indicate that a maternal GI nematode infection during pregnancy and lactation positively influences the spatial memory of uninfected juvenile offspring with potential fitness implications for the next generation.
Collapse
Affiliation(s)
- Sophia C Noel
- Institute of Parasitology, McGill University (Macdonald Campus), 21,111 Lakeshore Road, Ste-Anne de Bellevue, Quebec, H9X 3V9, Canada
| | - Liana Fortin-Hamel
- Institute of Parasitology, McGill University (Macdonald Campus), 21,111 Lakeshore Road, Ste-Anne de Bellevue, Quebec, H9X 3V9, Canada
| | - Manjurul Haque
- Institute of Parasitology, McGill University (Macdonald Campus), 21,111 Lakeshore Road, Ste-Anne de Bellevue, Quebec, H9X 3V9, Canada
| | - Marilyn E Scott
- Institute of Parasitology, McGill University (Macdonald Campus), 21,111 Lakeshore Road, Ste-Anne de Bellevue, Quebec, H9X 3V9, Canada.
| |
Collapse
|
35
|
Kukuia KKE, Torbi J, Amoateng P, Adutwum-Ofosu KK, Koomson AE, Appiah F, Tagoe TA, Mensah JA, Ameyaw EO, Adi-Dako O, Amponsah SK. Gestational iron supplementation reverses depressive-like behavior in post-partum Sprague Dawley rats: Evidence from behavioral and neurohistological studies. IBRO Neurosci Rep 2022; 12:280-296. [PMID: 35746978 PMCID: PMC9210498 DOI: 10.1016/j.ibneur.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background Postpartum depression is a mood disorder that affects about 9–20% of women after child birth. Reports suggest that gestational iron deficiency can cause a deficit in behavioral, cognitive and affective functions and can precipitate depressive symptoms in mothers during the postpartum period. The present study examined the effect of iron supplementation on depressive behavior during postpartum period in a rat model. Method Female Sprague-Dawley rats were crossed. Pregnant rats received iron, fluoxetine, desferrioxamine or vehicle throughout the period of gestation. During the postpartum period, mothers from all groups were taken through the open field test (OFT), forced swim test (FST), novelty-induced hypophagia (NIH) and sacrificed for histological examination of the brains. Results Results showed that rats treated with iron-chelating agent, desferrioxamine, and vehicle during gestation exhibited increased immobility scores in the FST, increased latency to feed and reduced feeding in the NIH with corresponding decreased number of neurons and dendritic branches in the cortex of the brain. These depression-related effects were attenuated by perinatal iron supplementation which showed decreased immobility scores in the FST comparable to rats treated with fluoxetine, a clinically effective antidepressant. Iron treatment also decreased latency to feeding while increasing feeding behavior in the NIH. Iron-treated dams had a higher number of neurons with dendritic connections in the frontal cortex compared to vehicle- and desferrioxamine-treated groups. Conclusion The results suggest that, iron supplementation during gestation exerts an antidepressant-like effect in postpartum Sprague-Dawley rats, attenuates neuronal loss associated with depression and increases dendritic spine density. Iron supplementation during gestation exerts an antidepressant-like effect in postpartum Sprague-Dawley rats. Iron supplementation during gestation attenuates neuronal loss associated with depression. Iron-treated dams had a higher number of neurons with dendritic connections in the frontal cortex.
Collapse
|
36
|
Isasi E, Figares M, Abudara V, Olivera-Bravo S. Gestational and Lactational Iron Deficiency Anemia Impairs Myelination and the Neurovascular Unit in Infant Rats. Mol Neurobiol 2022; 59:3738-3754. [PMID: 35381889 DOI: 10.1007/s12035-022-02798-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 03/09/2022] [Indexed: 11/25/2022]
Abstract
Iron deficiency anemia is a prevalent health problem among pregnant women and infants, particularly in the developing countries that causes brain development deficits and poor cognitive outcomes. Since tissue iron depletion may impair myelination and trigger cellular hypoxic signaling affecting blood vessels, we studied myelination and the neurovascular unit (NVU) in infant rats born to mothers fed with an iron deficient (ID) or control diet from embryonic day 5 till weaning. Blood samples and brains of rat pups at postnatal day (PND) 14 and 30 were analyzed. PND 14 ID rats had severe microcytic hypochromic anemia that was almost reversed at PND 30 although hypomyelination and astrocyte immature phenotype in the corpus callosum were significant at that age. In CA1 hippocampal region, PND 14 and PND 30 ID rats showed significant reduced expression of the receptor β of the platelet-derived growth factor localized in pericytes and associated to aquaporin 4 (AQP4) immunopositive capillaries. Shorter AQP4 + capillaries and reduced AQP4 expression were also evidenced in PND 14 and PND 30 ID rats. In addition, pericyte membrane permeability through large-pore channels was transiently increased in ID rats at PND 14 but not at PND 30, while the blood-brain barrier permeability was not affected. Remarkably, transient increased pericyte permeability found in PND 14 ID rats was not directly related to iron depletion, suggesting the involvement of other iron deficiency anemia-induced mechanisms. In summary, severe ID during gestation and lactation produces persistent hypomyelination and significantly affects hippocampal pericytes and astrocytes in the NVU which may trigger impaired neurovascular function.
Collapse
Affiliation(s)
- Eugenia Isasi
- Neurobiología Celular y Molecular, Instituto de Investigaciones Biológicas Clemente Estable (IIBCE), 3318, Italia Av., 11600, Montevideo, Uruguay
- Neurobiología Celular y Molecular, Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Martin Figares
- Neurobiología Celular y Molecular, Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Verónica Abudara
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Silvia Olivera-Bravo
- Neurobiología Celular y Molecular, Instituto de Investigaciones Biológicas Clemente Estable (IIBCE), 3318, Italia Av., 11600, Montevideo, Uruguay.
| |
Collapse
|
37
|
Nampijja M, Mutua AM, Elliott AM, Muriuki JM, Abubakar A, Webb EL, Atkinson SH. Low Hemoglobin Levels Are Associated with Reduced Psychomotor and Language Abilities in Young Ugandan Children. Nutrients 2022; 14:nu14071452. [PMID: 35406065 PMCID: PMC9002834 DOI: 10.3390/nu14071452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 12/10/2022] Open
Abstract
Children living in Sub-Saharan Africa are vulnerable to developmental delay, particularly in the critical first five years due to various adverse exposures including disease and nutritional deficiencies. Anemia and iron deficiency (ID) are highly prevalent in pregnant mothers and young children and are implicated in abnormal brain development. However, available evidence on the association between anemia, ID and neurodevelopment in sub-Saharan Africa is limited. Using data from the Entebbe Mother and Baby Study prospective birth cohort, we examined the effect of maternal and child hemoglobin (Hb) levels and child iron status on developmental scores in 933 and 530 pre-school Ugandan children respectively. Associations between Hb levels, iron status and developmental scores were assessed using regression analyses adjusting for potential confounders. Lower maternal and child Hb levels were associated with reduced psychomotor scores at 15 months, while only lower Hb levels in infancy were associated with reduced language scores. We found no evidence that anemia or ID was associated with cognitive or motor scores at five years. This study emphasizes the importance of managing anemia in pregnancy and infancy and highlights the need for further studies on the effects of anemia and ID in children living in Sub-Saharan Africa.
Collapse
Affiliation(s)
- Margaret Nampijja
- Maternal and Child Wellbeing (MCW) Unit, African Population and Health Research Center, Nairobi 00100, Kenya;
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe P.O. Box 49, Uganda;
| | - Agnes M. Mutua
- Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme, KEMRI Centre for Geographic Medicine Research-Coast, Kilifi 230-80108, Kenya; (J.M.M.); (A.A.)
- Correspondence: (A.M.M.); (S.H.A.); Tel.: +254-709983677-76 (A.M.M. & S.H.A.)
| | - Alison M. Elliott
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe P.O. Box 49, Uganda;
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - John Muthii Muriuki
- Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme, KEMRI Centre for Geographic Medicine Research-Coast, Kilifi 230-80108, Kenya; (J.M.M.); (A.A.)
| | - Amina Abubakar
- Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme, KEMRI Centre for Geographic Medicine Research-Coast, Kilifi 230-80108, Kenya; (J.M.M.); (A.A.)
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi 195-80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- Institute for Human Development, Aga Khan University, Nairobi 30270-00100, Kenya
| | - Emily L. Webb
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Sarah H. Atkinson
- Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme, KEMRI Centre for Geographic Medicine Research-Coast, Kilifi 230-80108, Kenya; (J.M.M.); (A.A.)
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
- Department of Paediatrics, University of Oxford, Oxford OX3 9DU, UK
- Correspondence: (A.M.M.); (S.H.A.); Tel.: +254-709983677-76 (A.M.M. & S.H.A.)
| |
Collapse
|
38
|
Nieto-Ruiz A, García-Santos JA, Verdejo-Román J, Diéguez E, Sepúlveda-Valbuena N, Herrmann F, Cerdó T, De-Castellar R, Jiménez J, Bermúdez MG, Pérez-García M, Miranda MT, López-Sabater MC, Catena A, Campoy C. Infant Formula Supplemented With Milk Fat Globule Membrane, Long-Chain Polyunsaturated Fatty Acids, and Synbiotics Is Associated With Neurocognitive Function and Brain Structure of Healthy Children Aged 6 Years: The COGNIS Study. Front Nutr 2022; 9:820224. [PMID: 35356726 PMCID: PMC8959863 DOI: 10.3389/fnut.2022.820224] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/01/2022] [Indexed: 12/25/2022] Open
Abstract
Background Adequate nutrient intake during the first few months of life plays a critical role on brain structure and function development. Objectives To analyze the long-term effects of an experimental infant formula (EF) on neurocognitive function and brain structure in healthy children aged 6 years compared to those fed with a standard infant formula or breastfed. Methods The current study involved 108 healthy children aged 6 years and participating in the COGNIS Study. At 0-2 months, infants were randomized to receive up to 18 months of life a standard infant formula (SF) or EF enriched with milk fat globule membrane (MFGM), long-chain polyunsaturated fatty acids (LC-PUFAs) and synbiotics. Furthermore, a reference group of breastfed (BF) infants were also recruited. Children were assessed using neurocognitive tests and structural Magnetic Resonance Imaging (MRI) at 6 years old. Results Experimental infant formula (EF) children showed greater volumes in the left orbital cortex, higher vocabulary scores and IQ, and better performance in an attention task than BF children. EF children also presented greater volumes in parietal regions than SF kids. Additionally, greater cortical thickness in the insular, parietal, and temporal areas were found in children from the EF group than those fed with SF or BF groups. Further correlation analyses suggest that higher volumes and cortical thickness of different parietal and frontal regions are associated with better cognitive development in terms of language (verbal comprehension) and executive function (working memory). Finally, arachidonic acid (ARA), adrenic acid (AdA), docosahexaenoic acid (DHA) levels in cheek cell glycerophospholipids, ARA/DHA ratio, and protein, fatty acid, and mineral intake during the first 18 months of life seem to be associated with changes in the brain structures at 6 years old. Conclusions Supplemented infant formula with MFGM components, LC-PUFAs, and synbiotics seems to be associated to long-term effects on neurocognitive development and brain structure in children at 6 years old. Clinical Trial Registration https://www.clinicaltrials.gov/, identifier: NCT02094547.
Collapse
Affiliation(s)
- Ana Nieto-Ruiz
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - José A. García-Santos
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Juan Verdejo-Román
- Department of Personality, Assessment & Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
| | - Estefanía Diéguez
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Natalia Sepúlveda-Valbuena
- Nutrition and Biochemistry Department, Faculty of Sciences, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Florian Herrmann
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Tomás Cerdó
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
- Carlos III Health Institute, Madrid, Spain
| | | | | | - Mercedes G. Bermúdez
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Miguel Pérez-García
- Department of Personality, Assessment & Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Centre—CIMCYC, University of Granada, Granada, Spain
| | - M. Teresa Miranda
- Department of Biostatistics, School of Medicine, University of Granada, Granada, Spain
| | - M. Carmen López-Sabater
- Department of Nutrition, Food Sciences and Gastronomy, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentària de la UB (INSA-UB), Barcelona, Spain
- National Network of Research in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III (Barcelona's Node), Madrid, Spain
| | - Andrés Catena
- Mind, Brain and Behavior Research Centre—CIMCYC, University of Granada, Granada, Spain
- Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain
| | - Cristina Campoy
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
- National Network of Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III (Granada's Node), Madrid, Spain
| |
Collapse
|
39
|
The Impact of Preconception Gastric Bypass Surgery on Maternal Micronutrient Status before and during Pregnancy: A Retrospective Cohort Study in the Netherlands between 2009 and 2019. Nutrients 2022; 14:nu14040736. [PMID: 35215386 PMCID: PMC8876006 DOI: 10.3390/nu14040736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 12/15/2022] Open
Abstract
Post-bariatric weight loss can cause iatrogenic malnutrition and micronutrient depletion. In this study, we evaluated the impact of gastric bypass surgery (GB) and multivitamin supplement use on maternal micronutrient status before and across pregnancy. A retrospective medical chart review of 197 singleton pregnancies after GB with a due date between 2009 and 2019 was performed at a bariatric expertise center in the Netherlands. Hemoglobin, calcium, iron status, folate, vitamin D, vitamin B12 and ferritin levels were determined before and after GB during standard follow-up and at all gestational trimesters and analyzed using linear mixed models. Patients were prescribed standard multivitamin supplements or multivitamins specifically developed for post-bariatric patients (FitForMe WLS Forte (FFM)). Overall, hemoglobin and calcium levels decreased after surgery and during pregnancy, whereas folate, vitamin D, and vitamin B12 levels increased, and iron levels remained stable. FFM use was associated with higher hemoglobin, folate, vitamin D, and ferritin levels. In conclusion, through adequate supplementation and follow-up, GB does not have to result in impaired micronutrient status. Supplements developed specifically for post-bariatric patients generally result in higher micronutrient values than regular multivitamins before and during pregnancy. These data emphasize the urgent need for nutritional counseling including dietary and multivitamin supplement advise for post-bariatric women contemplating and during pregnancy.
Collapse
|
40
|
Tutun H, Aluç Y, Kahraman HA, Sevin S, Yipel M, Ekici H. The content and health risk assessment of selected elements in bee pollen and propolis from Turkey. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2021.104234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
41
|
Christensen RD, Bahr TM, Ward DM. Iron deficiency in newborn infants: global rewards for recognizing and treating this silent malady. NEWBORN (CLARKSVILLE, MD.) 2022; 1:97-103. [PMID: 35949271 PMCID: PMC9361392 DOI: 10.5005/jp-journals-11002-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Robert D Christensen
- Divisions of Neonatology and Hematology, Department of Pediatrics, and Division of Microbiology and Immunology, Department of Pathology, and the Center for Iron and Heme Disorders, University of Utah Health, and Women and Newborn's Research, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Timothy M Bahr
- Divisions of Neonatology and Hematology, Department of Pediatrics, and Division of Microbiology and Immunology, Department of Pathology, and the Center for Iron and Heme Disorders, University of Utah Health, and Women and Newborn's Research, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Diane M Ward
- Divisions of Neonatology and Hematology, Department of Pediatrics, and Division of Microbiology and Immunology, Department of Pathology, and the Center for Iron and Heme Disorders, University of Utah Health, and Women and Newborn's Research, Intermountain Healthcare, Salt Lake City, Utah, USA
| |
Collapse
|
42
|
Zeisler H, Dietrich W, Heinzl F, Klaritsch P, Humpel V, Moertl M, Obruca C, Wimazal F, Ramoni A, Tiechl J, Wentzel‐Schwarz E. Prevalence of iron deficiency in pregnant women: A prospective cross-sectional Austrian study. Food Sci Nutr 2021; 9:6559-6565. [PMID: 34925785 PMCID: PMC8645778 DOI: 10.1002/fsn3.2588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 12/01/2022] Open
Abstract
The aim of the study was to determine, for the first time, in a prospective cross-sectional multicenter study, the prevalence of iron deficiency (ID) in an Austrian pregnant population. A cohort of 425 pregnant women was classified into four groups of different weeks of gestation. Group 1 was monitored longitudinally, while groups 2-4, iron status, were sampled only once. Evaluation of the prevalence of ID was performed by comparing the diagnostic criteria of the WHO to the cutoff proposed by Achebe MM and Gafter-Gvili A (Achebe) and the Austrian Nutrition Report (ANR). In comparison with the ANR, the prevalence of ID was lower in group 1 and higher in groups 2-4 (17.2% vs. 12.17%, 25.84%, 35.29%, and 41.76%, respectively) (p-values < .01 except group 1). According to WHO, the prevalence in group 1 was 12.17% at inclusion, 2 months later 31.7%, and further 2 months later 65.71%, respectively. According to Achebe, the number of cases doubled; for group 1, the number of cases rose from 13 to 42 (115 patients total); for groups 2-4, we observed an increase from 112 to 230 (340 patients total). This study reported a prevalence of around 12% at the beginning of pregnancy, which increased during pregnancy up to 65%. ID can have a massive impact on quality of life, justifying screening, as iron deficiency would be easy to diagnose and treat.
Collapse
Affiliation(s)
- Harald Zeisler
- Department of Obstetrics and GynaecologyMedical University ViennaViennaAustria
| | - Wolf Dietrich
- Department of Obstetrics and GynaecologyKarl Landsteiner University of Health SciencesUniversity Hospital TullnTullnAustria
| | - Florian Heinzl
- Department of Obstetrics and GynaecologyMedical University ViennaViennaAustria
| | - Philipp Klaritsch
- Department of Obstetrics and GynaecologyMedical University GrazGrazAustria
| | - Victoria Humpel
- Department of Obstetrics and GynaecologyMedical University GrazGrazAustria
| | - Manfred Moertl
- Department of Gynecology and ObstetricsPerinatal Center, Klagenfurt am WörtherseeKlagenfurtAustria
| | - Christian Obruca
- Department of Obstetrics and GynaecologyKarl Landsteiner University of Health SciencesUniversity Hospital TullnTullnAustria
| | - Friedrich Wimazal
- Department of Obstetrics and GynaecologyMedical University ViennaViennaAustria
| | - Angela Ramoni
- Department of Obstetrics and GynaecologyMedical University InnsbruckInnsbruckAustria
| | - Johanna Tiechl
- Department of Obstetrics and GynaecologyMedical University InnsbruckInnsbruckAustria
| | | |
Collapse
|
43
|
Miniello VL, Verga MC, Miniello A, Di Mauro C, Diaferio L, Francavilla R. Complementary Feeding and Iron Status: " The Unbearable Lightness of Being" Infants. Nutrients 2021; 13:4201. [PMID: 34959753 PMCID: PMC8707490 DOI: 10.3390/nu13124201] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/23/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
The complementary feeding (CF) period that takes place between 6 and 24 months of age is of key importance for nutritional and developmental reasons during the transition from exclusively feeding on milk to family meals. In 2021, a multidisciplinary panel of experts from four Italian scientific pediatric societies elaborated a consensus document on CF, focusing in particular on healthy term infants. The aim was to provide healthcare providers with useful guidelines for clinical practice. Complementary feeding is also the time window when iron deficiency (ID) and iron deficiency anemia (IDA) are most prevalent. Thus, it is appropriate to address the problem of iron deficiency through nutritional interventions. Adequate iron intake during the first two years is critical since rapid growth in that period increases iron requirements per kilogram more than at any other developmental stage. Complementary foods should be introduced at around six months of age, taking into account infant iron status.
Collapse
Affiliation(s)
- Vito Leonardo Miniello
- Nutrition Unit, Department of Pediatrics, “Giovanni XXIII” Children Hospital, “Aldo Moro” University of Bari, 70126 Bari, Italy
| | | | - Andrea Miniello
- Department of Allergology and Immunology, “Aldo Moro” University of Bari, 70124 Bari, Italy;
| | - Cristina Di Mauro
- Regional Centre of Pharmacovigilance Campania, Department of Experimental Medicine, University “Luigi Vanvitelli”, 80138 Naples, Italy;
| | | | - Ruggiero Francavilla
- Gastroenterology Unit, Department of Pediatrics, “Giovanni XXIII” Children Hospital, “Aldo Moro” University of Bari, 70126 Bari, Italy;
| |
Collapse
|
44
|
Suboptimal iron deficiency screening in pregnancy and the impact of socioeconomic status in a high-resource setting. Blood Adv 2021; 5:4666-4673. [PMID: 34459878 PMCID: PMC8759118 DOI: 10.1182/bloodadvances.2021004352] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/31/2021] [Indexed: 12/16/2022] Open
Abstract
Iron deficiency (ID) anemia in pregnancy is associated with poor maternal and childhood outcomes, yet ferritin testing, the standard test for ID, is not considered part of routine prenatal bloodwork in Canada. We conducted a retrospective cohort study of 44 552 pregnant patients with prenatal testing at community laboratories in Ontario, Canada, to determine the prevalence of ferritin testing over 5 years. Secondary objectives were to determine the prevalence and severity of ID and to identify clinical and demographic variables that influence the likelihood of ID screening. A total of 59.4% of patients had a ferritin checked during pregnancy; 71.4% were ordered in the first trimester, when the risk of ID is lowest. Excluding patients with abnormally elevated ferritins, 25.2% were iron insufficient (30-44 µg/L) and 52.8% were iron deficient (≤29 µg/L) at least once in pregnancy. A total of 8.3% were anemic (hemoglobin <105 g/L). The proportion of anemic patients with a subsequent ferritin test in pregnancy ranged from 22% to 67% in the lowest and highest anemia severity categories, respectively. Lower annual household income was negatively associated with the odds of a ferritin test; compared with those in the fifth (ie, highest) income quintile, the odds of ferritin testing for patients in the first, second, and fourth quintiles were 0.83 (95% confidence interval [CI], 0.74-0.91), 0.82 (95% CI, 0.74-0.91), and 0.86 (95% CI, 0.77-0.97), respectively. These data highlight gaps in prenatal care and issues of health equity that warrant harmonization of obstetrical guidelines to recommend routine ferritin testing in pregnancy.
Collapse
|
45
|
Sharma AJ, Ford ND, Bulkley JE, Jenkins LM, Vesco KK, Williams AM. Use of the Electronic Health Record to Assess Prevalence of Anemia and Iron Deficiency in Pregnancy. J Nutr 2021; 151:3588-3595. [PMID: 34386820 PMCID: PMC9550311 DOI: 10.1093/jn/nxab254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/06/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the United States, the prevalence of anemia, iron deficiency (ID), and iron-deficiency anemia (IDA) during pregnancy remains largely unknown as data at the national or state level are limited or nonexistent, respectively. OBJECTIVES In an effort to identify opportunities to improve maternal health surveillance, we assessed the feasibility of anemia, ID, and IDA surveillance among first-trimester pregnancies using electronic health records (EHRs). METHODS We identified pregnancies among Kaiser Permanente Northwest members aged ≥18 y during 2005-2016 with first-trimester prenatal care (n = 41,991). Earliest laboratory test results for hemoglobin or hematocrit and ferritin were selected. We describe the proportion of pregnancies screened for and the prevalence of anemia, ID, and IDA; the concordance of anemia status by hemoglobin compared with hematocrit; and the proportion of pregnancies with laboratory-confirmed anemia that also had an International Classification of Diseases diagnostic code related to anemia. RESULTS Identified pregnancies included women who were 73.1% non-Hispanic (NH) white, 11.5% Hispanic, 8.5% NH Asian/Pacific Islander, and 2.9% NH black. Hemoglobin and hematocrit results were available for 92.7% (n = 38,923) pregnancies. Anemia prevalence was 2.7% (n = 1045) based on hemoglobin <11.0 g/dL or hematocrit <33%; 45.2% of anemia cases had both low hemoglobin and low hematocrit. Among pregnancies with anemia, 18.9% (n = 197) had a ferritin result; of those, 48.2% had ID (ferritin <15 μg/L). In pregnancies without anemia, 3.4% (n = 1275) had a ferritin result; of those, 23.5% had ID. Based on 1472 pregnancies with both anemia and ID assessed, prevalence of ID and IDA was 26.8% and 6.5%, respectively; estimates likely represent selective screening. CONCLUSIONS EHR data have potential to monitor anemia prevalence and trends in health systems where prenatal anemia screening is nearly universal. However, if iron assessment is not routine, then representative estimates of ID or IDA are unattainable.
Collapse
Affiliation(s)
- Andrea J Sharma
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA,US Public Health Service Commissioned Corps, Atlanta, GA, USA
| | - Nicole D Ford
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA,McKing Consulting Corporation, Fairfax, VA, USA
| | | | | | - Kimberly K Vesco
- Kaiser Permanente Center for Health Research, Portland, OR, USA,Department of Obstetrics & Gynecology, Kaiser Permanente Northwest, Portland, OR, USA
| | - Anne M Williams
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA,McKing Consulting Corporation, Fairfax, VA, USA
| |
Collapse
|
46
|
Davies S, Briand V, Accrombessi M, Fievet N, Le Bot B, Durand S, Agbota G, Yovo E, Vianou B, Sossou D, Martin-Prevel Y, Massougbodji A, Cot M, Glorennec P, Bodeau-Livinec F. Pre-conception serum ferritin concentrations are associated with metal concentrations in blood during pregnancy: A cohort study in Benin. ENVIRONMENTAL RESEARCH 2021; 202:111629. [PMID: 34242675 DOI: 10.1016/j.envres.2021.111629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/20/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Iron deficiency is a common nutritional deficiency that impacts maternal health and fetal development and is also associated with increased uptake of toxic metals. Women in sub-Saharan Africa are highly exposed to both iron deficiency and metals in the environment. As research on the developmental origins of health and disease increasingly shows impacts of pre-conception maternal health on pregnancy and fetal health, these environmental exposures are of concern. OBJECTIVES This study investigated the association between iron status pre-pregnancy and blood metal concentrations in the first trimester of pregnancy with potential implications for iron supplementation. METHODS Pre-conception and first trimester blood samples taken from 262 Beninese women were tested for serum ferritin, inflammation markers, manganese (Mn), cadmium (Cd), lead (Pb), copper, zinc, selenium, mercury and arsenic. Associations between serum ferritin adjusted for inflammation and metal concentrations were analyzed using multivariate linear regression. RESULTS Women with iron deficiency before conception (13%) were more likely to remain iron deficient in the first trimester (4%) (adjusted OR = 41.2, 95%CI 6.2; 275.0) even within the context of routine iron supplementation during pregnancy. Lower pre-pregnancy serum ferritin concentrations were significantly related to higher concentrations of Mn, Cd and Pb in the first trimester. Every 1% increase in serum ferritin concentration was associated with a 0.13% decrease in Mn (adjusted β = -0.13, 95%CI -0.18; -0.07), a 0.22% decrease in Cd (adjusted β = -0.22, 95%CI -0.28; -0.15) and a 0.06% decrease in Pb concentration (adjusted β = -0.06, 95%CI -0.12; -0.006). DISCUSSION These results suggest that increasing iron stores prior to pregnancy may prevent excessive uptake of toxic concentrations of the metals Mn, Cd and Pb and argue in favour of testing the effects of iron supplementation prior to pregnancy on metal concentrations.
Collapse
Affiliation(s)
- Sarah Davies
- Département Méthodes Quantitatives en Santé Publique (METIS), Ecole des Hautes Etudes en Santé Publique (EHESP), F-35000, Rennes, France; Université de Paris, Center of Research in Epidemiology and Statistics/CRESS, INSERM, INRA, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé)-UMR1153, F-75004, Paris, France.
| | - Valérie Briand
- Institut de Recherche Pour le Développement (IRD), University of Bordeaux, Inserm, UMR 1219, 146 rue Léo-Saignat, 33076, Bordeaux, Cedex, France; Université de Paris, MERIT, IRD, 75006, Paris, France.
| | - Manfred Accrombessi
- Institut de Recherche Clinique du Benin (IRCB), 04 BP1114, Abomey-Calavi, Benin; Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Nadine Fievet
- Institut de Recherche Clinique du Benin (IRCB), 04 BP1114, Abomey-Calavi, Benin; Institut de Recherche pour le Développement (IRD), Paris Descartes Université, 75006, Paris, France.
| | - Barbara Le Bot
- Ecole des Hautes Études en Santé Publique (EHESP), Institut National de la Sante et de la Recherche Medicale (Inserm), Institut de Recherche en Santé, Environnement et Travail (Irset)-UMR_S 1085, University of Rennes, F-35000, Rennes, France.
| | - Séverine Durand
- Ecole des Hautes Études en Santé Publique (EHESP), Institut National de la Sante et de la Recherche Medicale (Inserm), Institut de Recherche en Santé, Environnement et Travail (Irset)-UMR_S 1085, University of Rennes, F-35000, Rennes, France.
| | - Gino Agbota
- Institut de Recherche Clinique du Benin (IRCB), 04 BP1114, Abomey-Calavi, Benin.
| | - Emmanuel Yovo
- Institut de Recherche Clinique du Benin (IRCB), 04 BP1114, Abomey-Calavi, Benin.
| | - Bertin Vianou
- Institut de Recherche Clinique du Benin (IRCB), 04 BP1114, Abomey-Calavi, Benin.
| | - Darius Sossou
- Institut de Recherche Clinique du Benin (IRCB), 04 BP1114, Abomey-Calavi, Benin.
| | - Yves Martin-Prevel
- Nutripass Research Unit, Institut de Recherche pour le Développement (IRD), University of Montpellier, SupAgro, Montpellier, France.
| | | | - Michel Cot
- Université de Paris, MERIT, IRD, 75006, Paris, France.
| | - Philippe Glorennec
- Ecole des Hautes Études en Santé Publique (EHESP), Institut National de la Sante et de la Recherche Medicale (Inserm), Institut de Recherche en Santé, Environnement et Travail (Irset)-UMR_S 1085, University of Rennes, F-35000, Rennes, France.
| | - Florence Bodeau-Livinec
- Département Méthodes Quantitatives en Santé Publique (METIS), Ecole des Hautes Etudes en Santé Publique (EHESP), F-35000, Rennes, France; Université de Paris, Center of Research in Epidemiology and Statistics/CRESS, INSERM, INRA, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé)-UMR1153, F-75004, Paris, France.
| |
Collapse
|
47
|
Bardestani A, Ebrahimpour S, Esmaeili A, Esmaeili A. Quercetin attenuates neurotoxicity induced by iron oxide nanoparticles. J Nanobiotechnology 2021; 19:327. [PMID: 34663344 PMCID: PMC8522232 DOI: 10.1186/s12951-021-01059-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/24/2021] [Indexed: 01/19/2023] Open
Abstract
Iron oxide nanoparticles (IONPs) have been proposed as targeted carriers to deliver therapeutic molecules in the central nervous system (CNS). However, IONPs may damage neural tissue via free iron accumulation, protein aggregation, and oxidative stress. Neuroprotective effects of quercetin (QC) have been proven due to its antioxidant and anti-inflammatory properties. However, poor solubility and low bioavailability of QC have also led researchers to make various QC-involved nanoparticles to overcome these limitations. We wondered how high doses or prolonged treatment with quercetin conjugated superparamagnetic iron oxide nanoparticles (QCSPIONs) could improve cognitive dysfunction and promote neurogenesis without any toxicity. It can be explained that the QC inhibits protein aggregation and acts against iron overload via iron-chelating activity, iron homeostasis genes regulation, radical scavenging, and attenuation of Fenton/Haber-Weiss reaction. In this review, first, we present brain iron homeostasis, molecular mechanisms of iron overload that induced neurotoxicity, and the role of iron in dementia-associated diseases. Then by providing evidence of IONPs neurotoxicity, we discuss how QC neutralizes IONPs neurotoxicity, and finally, we make a brief comparison between QC and conventional iron chelators. In this review, we highlight that QC as supplementation and especially in conjugated form reduces iron oxide nanoparticles neurotoxicity in clinical application.
Collapse
Affiliation(s)
- Akram Bardestani
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, P.O. Box: 8174673441, Isfahan, Iran
| | - Shiva Ebrahimpour
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, P.O. Box: 8174673441, Isfahan, Iran
| | - Ali Esmaeili
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abolghasem Esmaeili
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, P.O. Box: 8174673441, Isfahan, Iran.
| |
Collapse
|
48
|
Association of Prenatal Maternal Anemia with Tics and Tourette's Syndrome in Offspring. J Pers Med 2021; 11:jpm11101038. [PMID: 34683179 PMCID: PMC8541066 DOI: 10.3390/jpm11101038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/22/2022] Open
Abstract
Iron deficiency anemia (IDA) accounts for most of the anemia in pregnancy, and iron is essential for neurodevelopment. Tics and Tourette’s syndrome (TS) are neurodevelopmental disorders that manifest in childhood. A few studies reported an inconclusive association between iron deficiency and tics in children. No study has investigated the relationship between prenatal maternal anemia and tics in children. We aimed to assess the relationship between prenatal anemia exposure and the incidence of tics or TS in offspring. We linked the Taiwan National Health Insurance Research Database to the Maternal and Child Health Database for the analysis and identified 153,854 children with prenatal anemia exposure and 2,014,619 children without prenatal anemia exposure from 2004 to 2016 and followed them through 2017. Cox regression models were applied to compare the risk of tics or TS between the exposed and nonexposed groups. Among the exposed group, 37,832 were exposed at ≤12 weeks of gestational age (GA) and 116,022 at >12 weeks of GA. We observed an increased risk of tics and TS in those exposed at ≤12 weeks compared with the nonexposed group (adjusted hazard ratio (aHR) = 1.23, 95% confidence interval (CI): 1.12–1.34). The result remained consistent after adjusting for birth year, sex, birth order, maternal age, low-income levels, gestational age, birth weight, and alcohol use and smoking during pregnancy (aHR = 1.16, CI: 1.04–1.28). Fetuses exposed to maternal anemia at ≤12 weeks of GA are at high risk of tics or TS. However, this effect was attenuated to insignificance in the sibling comparison. Our study highlights the importance of detection of anemia during pregnancy and proper timing of iron supplementation.
Collapse
|
49
|
Li D, Liu Y, Zeng X, Xiong Z, Yao Y, Liang D, Qu H, Xiang H, Yang Z, Nie L, Wu PY, Wang R. Quantitative Study of the Changes in Cerebral Blood Flow and Iron Deposition During Progression of Alzheimer's Disease. J Alzheimers Dis 2021; 78:439-452. [PMID: 32986675 DOI: 10.3233/jad-200843] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Advanced Alzheimer's disease (AD) has no effective treatment, and identifying early diagnosis markers can provide a time window for treatment. OBJECTIVE To quantify the changes in cerebral blood flow (CBF) and iron deposition during progression of AD. METHODS 94 subjects underwent brain imaging on a 3.0-T MRI scanner with techniques of three-dimensional arterial spin labeling (3D-ASL) and quantitative susceptibility mapping (QSM). The subjects included 22 patients with probable AD, 22 patients with mild cognitive impairment (MCI), 25 patients with subjective cognitive decline (SCD), and 25 normal controls (NC). The CBF and QSM values were obtained using a standardized brain region method based on the Brainnetome Atlas. The differences in CBF and QSM values were analyzed between and within groups using variance analysis and correlation analysis. RESULTS CBF and QSM identified several abnormal brain regions of interest (ROIs) at different stages of AD (p < 0.05). Regionally, the CBF values in several ROIs of the AD and MCI subjects were lower than for NC subjects (p < 0.001). Higher QSM values were observed in the globus pallidus. The CBF and QSM values in multiple ROI were negatively correlated, while the putamen was the common ROI of the three study groups (p < 0.05). The CBF and QSM values in hippocampus were cross-correlated with scale scores during the progression of AD (p < 0.05). CONCLUSION Iron deposition in the basal ganglia and reduction in blood perfusion in multiple regions existed during the progression of AD. The QSM values in putamen can be used as an imaging biomarker for early diagnosis of AD.
Collapse
Affiliation(s)
- Dongxue Li
- Department of Radiology, Guizhou Provincial People's Hospital, Key Laboratory of Intelligent Medical Imaging Analysis and Accurate Diagnosis of Guizhou Province, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guiyang, China
| | - Yuancheng Liu
- Department of Radiology, Guizhou Provincial People's Hospital, Key Laboratory of Intelligent Medical Imaging Analysis and Accurate Diagnosis of Guizhou Province, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guiyang, China
| | - Xianchun Zeng
- Department of Radiology, Guizhou Provincial People's Hospital, Key Laboratory of Intelligent Medical Imaging Analysis and Accurate Diagnosis of Guizhou Province, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guiyang, China
| | - Zhenliang Xiong
- Department of Radiology, Guizhou Provincial People's Hospital, Key Laboratory of Intelligent Medical Imaging Analysis and Accurate Diagnosis of Guizhou Province, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guiyang, China
| | - Yuanrong Yao
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Daiyi Liang
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Hao Qu
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Hui Xiang
- Department of Psychology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Zhenggui Yang
- Department of Psychology, Guizhou Provincial People's Hospital, Guiyang, China
| | | | | | - Rongpin Wang
- Department of Radiology, Guizhou Provincial People's Hospital, Key Laboratory of Intelligent Medical Imaging Analysis and Accurate Diagnosis of Guizhou Province, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guiyang, China
| |
Collapse
|
50
|
Jones AD, Shi Z, Lambrecht NJ, Jiang Y, Wang J, Burmeister M, Li M, Lozoff B. Maternal Overweight and Obesity during Pregnancy Are Associated with Neonatal, but Not Maternal, Hepcidin Concentrations. J Nutr 2021; 151:2296-2304. [PMID: 33979838 PMCID: PMC8349130 DOI: 10.1093/jn/nxab133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/31/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Overweight or obesity among pregnant women may compromise maternal and neonatal iron status by upregulating hepcidin. OBJECTIVES This study determined the association of 1) maternal and neonatal iron status with maternal and neonatal hepcidin concentrations, and 2) maternal prepregnancy weight status with maternal and neonatal hepcidin concentrations. METHODS We examined hematologic data from 405 pregnant women and their infants from the placebo treatment group of a pregnancy iron supplementation trial in rural China. We measured hepcidin, serum ferritin (SF), soluble transferrin receptor (sTfR), and high-sensitivity C-reactive protein in maternal blood samples at mid-pregnancy and in cord blood at delivery. We used regression analysis to examine the association of maternal prepregnancy overweight or obese status with maternal hepcidin concentration in mid-pregnancy and cord hepcidin concentrations. We also used path analysis to examine mediation of the association of maternal prepregnancy overweight or obese status with maternal iron status by maternal hepcidin, as well as with neonatal hepcidin by neonatal iron status. RESULTS Maternal iron status was positively correlated with maternal hepcidin at mid-pregnancy (SF: r = 0.63, P < 0.001; sTfR: r = -0.37, P < 0.001). Neonatal iron status was also positively correlated with cord hepcidin (SF: r = 0.61, P < 0.001; sTfR: r = -0.39, P < 0.001). In multiple linear regression models, maternal prepregnancy overweight or obese status was not associated with maternal hepcidin at mid-pregnancy but was associated with lower cord hepcidin (coefficient = -0.21, P = 0.004). Using path analysis, we observed a significant indirect effect of maternal prepregnancy overweight or obese status on cord hepcidin, mediated by neonatal iron status. CONCLUSIONS In both pregnant women and neonates, hepcidin was responsive to iron status. Maternal prepregnancy overweight status, with or without including obese women, was associated with lower cord blood hepcidin, likely driven by lower iron status among the neonates of these mothers.
Collapse
Affiliation(s)
- Andrew D Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Zhen Shi
- Peking University First Hospital, Beijing, China
- Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Nathalie J Lambrecht
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Yaping Jiang
- Peking University First Hospital, Beijing, China
| | - Jingmin Wang
- Peking University First Hospital, Beijing, China
| | - Margit Burmeister
- Department of Computational Medicine & Bioinformatics, Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Ming Li
- Peking University First Hospital, Beijing, China
| | - Betsy Lozoff
- Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|