The Association between Maternal Dietary Iron Intake during the First Trimester of Pregnancy with Pregnancy Outcomes and Pregnancy-Related Complications

The Association between Maternal Dietary Iron Intake during the First Trimester of Pregnancy with Pregnancy Outcomes and Pregnancy-Related Complications
Hossein Hajianfar,¹ Khadijeh Abbasi,² Leila Azadbakht,³ Ahmad Esmaeilzadeh,⁴ Negar Mollaghasemi,^5,* Arman Arab,⁶
1. Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran.
2. Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran.
3. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran.
4. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran.
5. Student Research Committee, School of Nutrition and Food Sciences, Semnan University of Medical Sciences, Semnan 35131-19111, Iran.
6. Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
Introduction: In this study, we investigated the associations of maternal dietary iron intake during the first trimester of pregnancy and pregnancy outcomes and related complications in pregnant women of Isfahan, Iran.
Methods: In this prospective study, 812 healthy first-trimester singleton pregnant women were selected randomly from 20 various health centers across Isfahan city during 2015–2016. The maternal dietary iron classified into 2 groups, including heme and non-heme iron. Factors including pre-eclampsia, gestational hypertension, gestational diabetes mellitus, intrauterine growth restriction (IUGR), and nausea and vomiting in pregnancy considered as the pregnancy-related complications. Infant's birth weight, birth height, and birth head circumference were also determined as the pregnancy-outcomes.
Results: There was a significant association between total iron consumption and infant head circumference (p = 0.01). Total maternal iron (the sum of heme and non-heme iron) was negatively associated with both infant's birth height (p = 0.006) and birth weight (p = 0.02). Non-heme iron consumption is positively associated with high-risk of IUGR (p = 0.004). Heme intake was associated with an increased risk of maternal fasting blood sugar (FBS) (p = 0.04). Higher heme, non-heme, and total iron intake were associated with lower risk of pre-eclampsia (heme: crude p = 0.05; non-heme iron: adjusted p = 0.02; total iron: adjusted p = 0.05).
Conclusion: Maternal total iron intake was directly associated with infant head circumference, whereas, negatively associated with both birth weight and birth height. High non-heme iron intake may increase the risk of IUGR, and a high intake of heme iron may increase FBS.
Keywords: Dietary iron; Pregnancy outcome; Heme