Effect of iron deficiency anemia during pregnancy on T3, T 4 and TSH levels in newborns

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Suratmin Suratmin
Siska Mayasari Lubis
Melda Deliana
Hakimi Hakimi


Background Iron deficiency anemia (IDA) in infants is associated v.ith maternal iron deficiency anemia during pregnancy. Infants from anemic mothers often have lower hemoglobin levels than those from non􀁐anemic mothers. S everal studies have suggested that IDA in infants can impair thyroid peroxidase (TPO) enzyme which is required to produce thyroid hormones.

Objective To detennine the effects of IDA during pregnancy on T3, T4, and TSH levels in newborns.

Methods We conducted a cross􀁐sectional study from September to December 2010 in two hospitals. Mothers' blood specimens were examined for IDA. Newborns' hematocrit, hemoglobin, ferritin, T3, T4, and TSH levels were measured in umbilical vein blood
specimens taken at 24 hours of life.

Results Mean T3, T4, and TSH levels of 40 newborns whose mothers suffered from IDA were 2.2 nmollL (SD 1.19), 8.4 ug/dL (SD 6.12), and 15.3 mIU/mL (SD 3.99),  respectively. There was no significant relationship between maternal IDA during
pregnancy and infant T3 and TSH levels (P=0.96, P=0.29, respectively ). However, maternal IDA significantly correlated 'With infant T4 levels.

Conclusion There was no significant relationship between maternal IDA during pregnancy and levels of T3 and TSH in newborns. However, maternal IDA significantly correlated with lower infant T4 levels.

Article Details

How to Cite
Suratmin S, Lubis S, Deliana M, Hakimi H. Effect of iron deficiency anemia during pregnancy on T3, T 4 and TSH levels in newborns. PI [Internet]. 30Jun.2011 [cited 26Aug.2019];51(3):178-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/721
Received 2016-09-28
Accepted 2016-09-28
Published 2011-06-30


1. Ringoringo HP, Wahadiyah I, Sutrisna B, Setiabudy R, Suradi R. Model scoring waktu memprediksi anemia defisiensi besi pada bayi 0·6 bulan. Sari Pediatri. 2005;10,338-4.
2. Wiknjosastro H. Perubahan anatomik dan fisiologik pada warrita hamil. In : Wiknjosastro H, Saifuddin AB, Rachimhadhi T, editors. Hmu kebidanan. yd ed. Jakarta: Yayasan Bina Pustaka Sarwono Prav,irohardjo; 1999. p. 89􀁲101.
3. Amir I, Dhewi S. Anemia pada bayi premature. In: Abdussalam M, Trihono Pp, Kaswandani N, Endyarni B, editors. Pendekatan praktis pucat: Masalah kesehatan yang terabaikan pada bayi dan anak.Jakarta: Departemen Hmu Kesehatan Anak F KUI; 2007. p. 93·101.
4. Sonja Y, Michael, B Zumennann, Arnold M, Langhans W, Hurrel FR. Iron deficiency anemia reduced thyroid peroxidase activity in rats. Am Soc Nutr Sci. 2002; 22:1951-5.
5. Hauth JC, Leveno KJ, Gilstrap L, Bloom SL, Wenstrom KD. Placental development. In: Cunningham F G, Hauth JC, Leveno KJ, Gilstrap L, Bloom SL, Wenstrom KD, editors. William obstetrics.N ew York: McGraw-Hill; 2005. p . 5 7·82.
6. Tienboon P, Unacha K.lron deficiency anemia in childhood and thyroid function. Asia Pacific J Clin Nutr. 2003 ;12: 198-202.
7. Stoll BJ. The umbilicus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders Elsevier; 2007.p.775.
8. Zimmermann MB, Burgi H, Hurrel RF. Iron deficiency predicts poor maternal thyroid status during pregnancy. J Clin Endocrinol Metab. 2007;92,3436-40.
9. Gilbert WM, Machin GA. Fetal development. In : Ballard RA, editor. Avery's diseases of the newborn. 8th ed. Philadelphia : Saunders Elsevier; 2005. p. 23-30.
10. Beard JL, Barel MJ, Derr ]. Impaired thermoregulation and thyroid function in iron deficiency anemia. Am J Clin Nutr. 1990;52.813·9.
11. Saslow JG, M Ernest, A Carol, Southard A. Thyroid screening for early discharged infants. Am Assoc Pediatr. 2008;98;41-4.
12. Brown RS. The thyroid gland. In: Brook CG, Hinmars PC, Jacobs HS, editors. Clinical pediatric endocrinology. 4th ed. London: Blackwell Science; 2001. p. 288-316.
13. Brown RS. Thyroid disease in infancy, childhood, and adolescence. In: Bravennan LE, editor. Diseases of the thyroid. 2nded. New Jersey: Humana Press; 2003. p. 63-83.
14. Desposito F, Cho S, F rias JL, Sherman J, Wappner RS, Wilson MG. Newborn screening fact sheets. Pediatrics. 1996;98;473·500.
15. Fort PF, Bro\Vll RS. Thyroid disorders in infancy. In: Lifshitz F, editor. Pediatric endocrinology. yd ed. Brooklyn: Marcel Dekker; 1996. p. 369·81.
16. Kappy MS, Steelman JW, Travers SH, Zeitler PS. Endocrine disorders. In: Hay ww, Hayward AR, Levin MJ, Sondheimer JM, editors. Current pediatric diagnosis & treatment. 16th ed. North America: Lang Medical Books; 2003. p. 937-53.
17. Hou J, Cliver Sp, Tamura T, Johnston, KE, Goldenberg R. Maternal serum ferritin and fetal growth. Obstet Gynecol. 2009;95;447·52.
18. Manglik AK, Chatterjee N, Ghosh G. Umbilical cord blood TSH levels in tenn neonates: A screening tool for congenital hypothyroidsm. Indian Pediatr. 2005;42.1029·33.
19. Mercer JS, Skovgard RL. Neonatal transitional physiology: a new paradigm. J Perinatal Neonatal Nurs. 2002;1:56-76.
20. Philip AG, Saigal S. When should we clamp the umbilical cord? Neo Rev. 2004;5.142·53.
21. Aladangady N, McHugh S, Aitchison TC, Wardrop CA, Holland BM. Infants's blood volume in controlled trial of placental transfusion at preterm delivery. Pediatrics. 2006;117.93·8.
22. Usher R, Sephard M, Lind j. The blood volume of the newborn infant and placental transfusion. Acta Paediatr Scand.1963;52.497·512.
23. Singla PN, Chand S, Agarwal KN. Cord serum and placental tissue iron status in maternal hypothennia. AM]. 1979;32.1462·5.
24. Lozoff B. Iron deficiency in infancy: applying a physiologic framework for prediction. Am J Clin Nutr. 2006;84:1412-21.
25. Gomella TL. Polycythemia and hyperviscocity. In: Gomella TL,
Cunningham MD, Eyal F G, Zenk KE, editors. Neonatology: management, procedures, on call problems, diseases and drugs. 5,h ed. New York. McGraw-Hill; 2004. p. 341-4.
26. Sarkar S, Rosenkrantz TS. Neonatal polycythemia and hyperviscosity. F etal Neonatal Med. 2008;13:248-55.