Maternal Obesity Affects Inflammatory and Iron Indices in Umbilical Cord Blood

• Published in: The Journal of pediatrics Vol. 172; pp. 20 - 28
• Main Authors: Dosch, Natalie C., BS, Guslits, Elyssa F., MD, Weber, Morgan B., BS, Murray, Shannon E., BS, Ha, Barbara, BA, MSPH, Coe, Christopher L., PhD, Auger, Anthony P., PhD, Kling, Pamela J., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Adult; Body Mass Index; Cytokines - blood; Female; Fetal Blood - metabolism; Fetus - metabolism; Humans; Infant, Newborn; Inflammation - complications; Inflammation - metabolism; Iron - blood; Male; Maternal-Fetal Exchange; Obesity - blood; Pediatrics; Pregnancy; CRP; C-reactive protein; MNC; RBC distribution width; Interleukin; TNF; IFN; Body mass index; Zinc protoporphyrin to heme; RBC; T-helper; Mononuclear cell; Th; GWG; Hemoglobin; WBC; Hb; BMI; IL; RDW; ZnPP:H; Red blood cell; Tumor necrosis factor; Gestational weight gain; Interferon; White blood cell
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2016.02.023

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 30 kg/m2 or above or below 35 kg/m2 . Umbilical cord plasma 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 35 kg/m2 and above, predicted higher C-reactive protein and TNF-α in umbilical cord plasma ( 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 plasma TNF-α and MNC TNF-α was not linear but occurred when the threshold of BMI 35 kg/m2 was 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 35 kg/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 adults, was related to iron status and not obesity in fetuses. Pediatricians should be aware of these relationships.