Effect of adjusting prenatal iron supplementation on maternal iron status and child neurodevelopment

Identifier:  TDX:4283

Handle: https://hdl.handle.net/20.500.11797/TDX4283

Authors:  Iglesias Vázquez, Lucía

Abstract:
Both prenatal iron deficiency (ID) and excess have been associated with negative health consequences for mothers and children, such as reduced cognitive, language and motor skills, as well as behavioural problems in childhood. Prenatal iron supplementation has proven beneficial for cognitive and behavioural development in developing countries and anaemic women. However, routine supplementation in well-nourished women without ID may not provide clear benefits and could potentially harm child neurodevelopment. The debate between routine and personalized iron supplementation for non-anaemic women during early pregnancy continues, with limited research on the topic. This thesis aimed to evaluate the impact of adjusting prenatal iron supplementation to individual needs on iron status at the end of gestation and children's neurodevelopment, by involving data from the ECLIPSES and ECLIPSES-NEN studies (Spain). A secondary objective was to determine the potential predictors of maternal iron status in early- and mid-pregnancy, which was assessed using data from the ECLIPSES study and the MoBa Cohort (Norway). The results indicate that adjusting iron supplementation improved maternal iron status, reducing both deficiency and excess in late pregnancy. This approach also enhanced cognitive functioning and reduced behavioural and psychological problems in children at age 4. Factors such as body mass index, parity, smoking, and diet were found to be associated with iron deficiency without anaemia during pregnancy, emphasizing the need to manage iron status in specific subgroups. Assessing serum ferritin levels and, sometimes, genetic conditions would help determine appropriate iron supplementation doses. In summary, the thesis highlights the importance of personalised iron supplementation during pregnancy considering individual factors when prescribing iron supplements and shows the long-term benefits on infant neurodevelopment.