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Minerals, trace elements, Vit. D and bone health

Impact of maternal, antenatal and birth-associated factors on iron stores at birth: data from a prospective maternal–infant birth cohort



Low serum ferritin concentrations at birth, which reflect neonatal iron stores, track through to early childhood and have been associated with poorer neurodevelopmental outcomes. We aimed to identify maternal, antenatal and birth-associated factors that influence iron stores at birth in a prospective maternal–infant birth cohort.


In a population-based, longitudinal, birth cohort in Ireland, 413 maternal–infant dyads with prospectively collected lifestyle and clinical data from 15 weeks’ gestation had umbilical cord serum ferritin concentrations measured. Regression models were developed to identify independent factors associated with cord ferritin concentrations.


Median (IQR) cord ferritin concentrations were 185.7 (131.7, 385.5) μg/l, and 8% (n=33) of infants had low iron stores (ferritin <76 μg/l) at birth. Maternal obesity (BMI 30 kg/m2) at 15 weeks’ gestation (adj. estimate (95% confidence interval (CI)): −66.4 (−106.9, −25.9) μg/l, P<0.0001) and delivery by caesarean section (−38.8 (−70.2, −7.4) μg/l, P=0.016) were inversely associated with cord ferritin concentrations. In addition, maternal smoking at 15 weeks’ gestation (adj. odds ratio (95% CI): 2.9 (1.2, 7), P=0.020) and being born small-for-gestational age (3.4 (1.3, 8.9), P=0.012) were associated with an increased risk of low iron stores (ferritin <76 μg/l) at birth.


We have identified a number of potentially modifiable lifestyle factors that influence iron stores at birth, with the important role of overall maternal health and lifestyle during pregnancy highlighted. Public health policies targeting women of child-bearing age to improve nutrition and health outcomes should be prioritised for the health of the next generation.

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We thank the participants and their families for their continued support, and both the SCOPE Ireland and Cork BASELINE Birth Cohort Study research teams. Funding A grant from the National Children’s Research Centre to DMM, JOBH, ADI, LCK and MEK is the primary funding source for the Cork BASELINE Birth Cohort Study. Additional support came from grants from the UK Food Standards Agency to JOBH and ADI and from Danone Nutricia Early Life Nutrition to MEK and DMM. The SCOPE Ireland Study was funded by a grant from the Health Research Board of Ireland (CSA 02/2007) to LCK. The INFANT Research Centre is Science Foundation Ireland funded (Grant No. 12/RC/2272). No funding agencies had any role in the design, analysis or writing of this article.

Author contributions

EKM carried out data collection, database construction and data analysis. EKM and MEK designed the study and drafted the manuscript. DMM is the overall principal investigator (PI) of the Cork BASELINE Birth Cohort Study; and JOBH, LCK, ADI and MEK are co-PIs and specialist leads. LCK is the PI of the SCOPE Ireland pregnancy cohort study. All authors reviewed and approved the final submission.

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Correspondence to M E Kiely.

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The authors declare no conflict of interest.

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McCarthy, E., Kenny, L., Hourihane, J. et al. Impact of maternal, antenatal and birth-associated factors on iron stores at birth: data from a prospective maternal–infant birth cohort. Eur J Clin Nutr 71, 782–787 (2017).

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