Journal
NUTRITION REVIEWS
Volume 71, Issue 8, Pages 528-540Publisher
OXFORD UNIV PRESS INC
DOI: 10.1111/nure.12049
Keywords
birth outcomes; infection; iron; maternal; neonatal; pregnancy; supplementation
Categories
Funding
- Max Elstein Trust
- Manchester Academic Health Science Centre
- Central Manchester University Hospital NHS Trust
- National Institutes of Health (NIH) [1U01HD061234-01A1]
- National Institute of Child Health and Human Development
- NIH Office of Dietary Supplements
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Infection is a major cause of neonatal death in developing countries. This review investigates whether host iron status affects the risk of maternal and/or neonatal infection, potentially contributing to neonatal death, and summarizes the iron acquisition mechanisms described for pathogens causing stillbirth, preterm birth, and congenital infection. In vitro evidence shows that iron availability influences the severity and chronicity of infections that cause these negative outcomes of pregnancy. In vivo evidence is lacking, as relevant studies of maternal iron supplementation have not assessed the effect of iron status on the risk of maternal and/or neonatal infection. Reducing iron-deficiency anemia among women is beneficial and should improve the iron stores of babies; moreover, there is evidence that iron status in young children predicts the risk of malaria and, possibly, the risk of invasive bacterial diseases. Caution with maternal iron supplementation is indicated in iron-replete women who may be at high risk of exposure to infection, although distinguishing between iron-replete and iron-deficient women is currently difficult in developing countries, where a point-of-care test is needed. Further research is indicated to investigate the risk of infection relative to iron status in mothers and babies in order to avoid iron intervention strategies that may result in detrimental birth outcomes in some groups of women. (C) 2013 International Life Sciences Institute
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