Background Iron deficiency during the fetal and neonatal (perinatal) period can result in dysfunction of multiple organ systems, some of which might not recover despite iron rehabilitation. The aim of the study was to assess whether infants born to mothers with gestational diabetes (GDMs)and large for gestational age (LGA) infants are at higher risk for iron-deficiency compared to matched healthy term controls.
Methods Infants born in Marmara University Hospital were enrolled. Infants of GDMs were assigned as group1 (n:22), LGA infants as group2 (n:17) and the control group was assigned as group3 (n:72). Blood samples for complete blood cell count, ferritin and serum transferrin receptor (sTfR) levels were obtained from cord blood. Blood hemoglobin, ferritin and sTfR levels were compared between the groups.
Results Median head circumference, height and weight of infants born to GDMs and LGA infants were significantly higher than that of the control group. When infants of GDMs and LGA infants were compared, bodyweight and height were significantly higher in the LGAgroup. Nosignificant differences were found in head circumference values between the groups. In groups 1.2.3 cord blood median hemoglobin, ferritin and sTfRlevels were 17.2; 15.4; 16.0(gr/dl)(p=0.05), 179.7; 252.3; 225.7(µg/L) (p=0.456) and 5.22; 4.34; 3.42 (mg/L) (p=0.008) respectively. Hemoglobin levels were higher in the infants of GDMs but this reached only borderline significance(p=0.05). Serum ferritin levels were found to be lower and sTfR levels were found to be higher in the infants of GDMs. The median serum transferrin receptor concentration in the infants of GDMs was significantly higher than that of both the control group and the LGA group. However, the differences between the groups in terms of ferritin were not statistically significant.
Conclusions Increased sTfR reflects tissue iron deficiency in children. Increased sTfR levels in infants of GDMs may indicate that they have an risk for iron deficiency. Optimal follow up is warranted in infants of GDMs to prevent perinatal iron deficiency and its consequences.