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Fetus

Poster Session 2

(560) Differences in fetal inflammatory markers among pregnancies treated with oral or intravenous iron supplementation

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Little is known about the effects of iron supplementation during pregnancy on fetal markers of inflammation. The objective of this study was to assess whether there are differences in umbilical cord blood (UCB) inflammatory markers among iron-deficient pregnant individuals receiving oral or intravenous (IV) iron supplementation.

Study Design: We performed a prospective non-randomized clinical trial comparing oral and IV iron supplementation in singleton, non-anomalous pregnancies (> 24 weeks gestation) with iron deficiency (ferritin < 30 ng/mL). Outcomes were UCB inflammatory markers: interferon (IFN) γ, interleukin (IL) 10, IL-13, IL-1β, IL-1α, IL-4, IL-6, and tumor necrosis factor (TNF) α. We compared UCB markers among oral and IV iron supplementation in the whole cohort and among pregnancies with female and male fetuses. Two-sample t-test or Wilcoxon rank sum tests were used for comparisons, when indicated. 

Results: Fifty-three individuals were included; 25 (47.2%) received oral iron and 28 (52.8%) received IV iron. We found no statistically significant differences in baseline demographics and UBC markers between treatment groups of oral and IV supplementation. Among pregnancies with female fetuses, IFNγ (1.63 ± 0.55 vs 1.27 ±0.31; p=0.04) and TNFα (14.95 [13.84-16.82] vs 11.69 [9.60-13.84]; p=0.003) were higher in the IV iron group compared to the oral iron group. We found no statistically significant differences in UCB markers among pregnancies with male fetuses.

Conclusion: There are no differences in fetal inflammatory markers between pregnancies treated with oral and IV iron supplementation overall, however when stratified by fetal sex there are few differences (IFNγ and TNFα were higher in the IV iron group in pregnancies with female fetuses), suggesting that treatment modalities such as IV iron may impact male and female fetuses differently. More information is needed to better assess the long-term effects of iron supplementation on neonatal and child development and these studies should conduct sex stratified analyses.