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Influence of maternal diabetes mellitus on fetal iron status
  1. Alison Maria Verner,
  2. John Manderson,
  3. Terrence R J Lappin,
  4. David R McCance,
  5. Henry L Halliday,
  6. David G Sweet
  1. Departments of Child Health and Haematology, Queen’s University Belfast, Regional Neonatal Unit, Royal Maternity Hospital, Belfast, and Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital
    Belfast, Northern Ireland
  1. Dr D G Sweet, Regional Neonatal Unit, Royal Maternity Hospital, Grosvenor Road, Belfast BT12 6BB, Northern Ireland; david.sweet{at}


Objective: To determine the effects of maternal diabetes on fetal iron status using serum transferrin receptors (STfR) and their ratio to ferritin (TfR-F index) in cord blood.

Methods: Iron, ferritin, erythropoietin, STfR and haemoglobin concentration were measured and TfR-F index calculated in 97 maternal/cord blood pairs. Forty-nine women had type 1 diabetes (diagnosed before pregnancy) and these were compared with forty-eight non- diabetic controls. The women with type 1 diabetes were recruited consecutively from attendance at the joint antenatal endocrine clinic while the control group of women was recruited from consecutive attendance at the remaining antenatal clinics.

Results: The infants of the diabetic women had significantly lower levels of ferritin (47 vs 169 μg/l; p<0.01) and higher STfR (17.4 vs 12.9 mg/l; p<0.01) and TfR-F index (10.4 vs 5.8; p<0.01) than controls. They were also significantly more acidotic at birth (7.25 vs 7.30; p<0.01), were born at an earlier gestation (36.7 vs 39.7 weeks; p<0.01) and had higher z Scores for weight (0.53 vs 0.02; p = 0.016).

Conclusions: Maternal diabetes causes depletion of fetal iron stores and is associated with higher fetal iron demands as indicated by higher STfR level and TfR-F index in cord blood.

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  • Competing interests: None.

  • Abbreviations:
    iron regulatory proteins
    serum transferrin receptors
    transferrin receptor
    TfR-F index
    transferrin receptor ferritin index