Maternal second-trimester serum ferritin concentrations and subsequent risk of preterm delivery.

Abstract

We studied the relationship between maternal second-trimester serum ferritin concentrations and preterm delivery. The 312 preterm delivery cases, studied in aggregate and in subgroups [spontaneous preterm labour, preterm premature rupture of membranes, medically induced preterm delivery, moderate preterm delivery (gestational age at delivery 34-36 weeks) and very preterm delivery (gestational age at delivery <34 weeks)] were compared with 424 randomly selected women who delivered at term. Maternal ferritin concentrations, measured in serum collected at 17 weeks gestation on average, was determined using a two-site chemiluminometric immunoassay. Using multiple logistic regression, we derived maximum likelihood estimates of adjusted odds ratios (OR) and 95% confidence intervals [CI]. Elevation in maternal second-trimester ferritin was weakly associated with the risk of preterm delivery overall. After adjusting for possible confounding by maternal age, race/ethnicity, parity, Medicaid payment status and smoking during the index pregnancy, the OR for extreme quartiles (>64.5 vs. <26.0 ng/mL) of ferritin was 1.3 [95% CI 0.8, 2.1]. Stratified analyses indicated that elevated maternal serum ferritin was associated with an increased risk of preterm premature rupture of membranes (OR = 2.1; 95% CI 1.1, 4.1), but not with spontaneous preterm labour (OR = 0.9; 95% CI 0.4, 1.7) or medically induced preterm delivery (OR = 1.1; 95% CI 0.6, 2.0). The relationship between elevated maternal second-trimester serum ferritin concentrations and preterm delivery was strongest for spontaneous very preterm deliveries (<34 weeks gestation). Women with ferritin concentrations in the highest decile (>96 ng/mL) experienced a 2.7-fold increased risk of delivering before 34 completed weeks, compared with women with concentrations <26.0 ng/mL. These results are consistent with some previous reports, and further underline the potential for heterogeneity in the aetiology of preterm delivery.

• Authors: Rong Xiao, Tanya K Sorensen, Ihunnaya O Frederick, Amira El-Bastawissi, Irena B King, Wendy M Leisenring, Michelle A Williams
• Journal: Paediatric and perinatal epidemiology (Paediatr Perinat Epidemiol) Vol. 16 Issue 4 Pg. 297-304 (Oct 2002) ISSN: 0269-5022 [Print] England
• PMID: 12445145 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Ferritins

Topics

• Adult
• Case-Control Studies
• Female
• Ferritins (blood)
• Fetal Membranes, Premature Rupture (blood)
• Humans
• Infant, Newborn
• Infant, Premature
• Logistic Models
• Obstetric Labor, Premature (blood)
• Odds Ratio
• Pregnancy
• Pregnancy Trimester, Second (blood)
• Risk Factors