Investigation of the relationship between cord blood ferritin levels and the development of early iron deficiency anemia in infants of diabetic mothers

Diabetes is an important problem with a frequency of 16% in pregnancy. All of maternal diabetes types brings with it many problems that affect newborn health, especially respiratory, metabolic and hematological problems. One of these problems is the insufficient iron stores due to various reasons such as increased iron need due to polycythemia and uteroplacental insufficiency in these babies. In this study, we aimed to evaluate the iron stores serially at birth and in the following months up to the 4th month on mountly basis and to determine the time of development of iron deficiency in infants with maternal diabetes who applied to our Neonatal unit of Uludag University Faculty of Medicine. Infants with maternal diabetes (Type 1 DM, Type 2 DM, gestational diabetes) who were born at 37 weeks and above, admitted to our neonatal unit between 25/12/2018-01/07/2021 were included in this prospective study. Haemoglobin, hematocrit, iron, iron binding capacity, and ferritin levels were compared with reference values in the literature, with monthly follow-ups from birth to the fourth month. A total of 86 infants were included in the study. Babies with blood incompatibility, born below 37 weeks of age, with a history of hypoxic birth, polycythemia for another reason, and hospitalized with a prediagnosis of respiratory distress or sepsis were not included in the study. It was found that 9% of the mothers of the 86 cases included had Type 1 DM, 15% had type 2 DM, and 76% had gestational DM (GDM). In the study, there was no significant difference between the groups in terms of gender, gestational week, birth weight, delivery type, diet, maternal age, multiparity, and iron use during pregnancy. Macrosomia was found in 17% of the patients, and hypoglycemia was found in 9.3% of the patients. When the distribution according to diabetes types was examined, macrosomia was detected at a significantly higher rate in patients with Type 2 DM and hypoglycemia was found at a significantly higher rate in patients with Type 1 DM. When the course of the median values of laboratory findings in terms of iron deficiency was examined in the four-month follow-up, it was observed that there was a decrease in Hb, Hct, iron, ferritin levels, and an increase in iron binding capacity. When we evaluated according to diabetes types, especially in cases with Type 1 DM, the lowest iron and ferritin levels and highest Hb and Hct levels were observed at birth and the lowest Hb and Hct levels were observed at the first month evaluations. In conclusion, this study showed that infants with maternal diabetes had insufficient iron stores at birth and decreased Hb, iron and ferritin levels in the following months, and the importance of following these infants in terms of iron deficiency. Keywords: Infants of diabetic mother, iron deficiency, iron storage