Maternal Obesity Affects Inflammatory and Iron Indices in Umbilical Cord Blood
Natalie C. Dosch,Elyssa F. Guslits,Morgan B. Weber,Shannon E. Murray,Barbara Ha
DOI:
http://dx.doi.org/10.1016/j.jpeds.2016.02.023 Abstract
Objective
To determine the impact of maternal obesity and gestational weight gain across pregnancy on fetal indices of inflammation and iron status.
Study design
Eighty-five healthy term newborns delivered via elective cesarean were categorized by 2 maternal body mass index (BMI) thresholds; above or below 30kg/m2or above or below 35kg/m2. Umbilical cord plaa levels of C-reactive protein, interleukin (IL)-6, tumor necrosis factor (TNF)-α, ferritin, and hepcidin were assayed. Cytokines released by phytohemagglutinin-stimulated umbilical cord mononuclear cells (MNCs) were assayed.
Results
Maternal class II obesity, defined as BMI of 35kg/m2and above, predicted higher C-reactive protein and TNF-α in umbilical cord plaa (P<.05 for both), and also proinflammatory cytokines (IL-1β, IL-6, and TNF-α) from stimulated MNC (P<.05 for all). The rise in plaa TNF-α and MNC TNF-α was not linear but occurred when the threshold of BMI 35kg/m2was reached (P<.005,P<.06). Poorer umbilical cord iron indices were associated with maternal obesity. When ferritin was low, IL-6 was higher (P<.04), but this relationship was present primarily when maternal BMI exceeded 35kg/m2(P<.03). Ferritin was correlated with hepcidin (P<.0001), but hepcidin was unrelated to either maternal BMI or inflammatory indices.
Conclusions
Class II obesity and above during pregnancy is associated with fetal inflammation in a threshold fashion. Although maternal BMI negatively impacted fetal iron status, hepcidin, related to obesity in s, was related to iron status and not obesity in fetuses. Pediatricians should be aware of these relationships.
