ABSTRACT
OBJECTIVE: To elucidate the role of maternal and neonatal iron status on placental transferrin receptor (TfR) expression. STUDY DESIGN AND OUTCOMES: Ninety-two healthy pregnant adolescents (ages 14-18 years) were followed across pregnancy. Maternal iron status (hemoglobin, hematocrit, serum ferritin, TfR, and total body iron) was assessed in mid-gestation (21-25 wks) and at delivery in the mother and neonate. Placental TfR protein expression was assessed by western blot in placental tissue collected at delivery. RESULTS: Placental TfR expression was inversely associated with maternal iron status at mid-gestation (hemoglobin p = 0.046, R(2) = 0.1 and hematocrit p = 0.005, R(2) = 0.24) and at delivery (serum ferritin p = 0.02, R(2) = 0.08 and total body iron p = 0.02, R(2) = 0.07). Mothers with depleted body iron stores had significantly greater placental expression of TfR than mothers with body iron stores greater than zero (p = 0.003). Neonatal iron stores were also inversely associated with the expression of placental TfR (p = 0.04, R(2) = 0.06). Neonates with serum ferritin values ≤ 34 µg/L had significantly greater protein expression of placental TfR compared to neonates with cord serum ferritin values >34 µg/L (p = 0.01). CONCLUSIONS: Expression of placental TfR is associated with both maternal and neonatal iron demands. Increased expression of placental TfR may be an important compensatory mechanism in response to iron deficiency in otherwise healthy pregnant women.
Subject(s)
Anemia, Iron-Deficiency/metabolism , Iron/metabolism , Nutritional Status , Placenta/metabolism , Pregnancy Complications, Hematologic/metabolism , Receptors, Transferrin/metabolism , Adolescent , Anemia, Iron-Deficiency/blood , Female , Ferritins/blood , Fetal Blood/chemistry , Hematocrit , Hemoglobins/analysis , Humans , Infant, Newborn , Iron/analysis , Longitudinal Studies , Male , Organ Size , Placenta/anatomy & histology , Placenta/chemistry , Pregnancy , Pregnancy Complications, Hematologic/blood , Pregnancy Trimester, Second , Severity of Illness IndexABSTRACT
A 52-year-old woman who had been apprehended for shoplifting was found to have normal-pressure hydrocephalus due to aqueduct stenosis. We ascribe the shoplifting to impairment of social judgment, which was one of the observed features of a dementia. Cerebrospinal fluid diversion by means of a ventriculo-peritoneal shunt resulted in resolution of her symptoms.
