Caesarean delivery may reduce neonatal iron stores at birth

Caesarean delivery appears to obstruct placental transfusion from mother to neonate and lessens iron stores at birth, a recent study suggests.

A team of investigators sought to estimate the association of caesarean delivery on maternal request (CDMR), a subtype of caesarean without any medical indications, with a spectrum of indicators reflecting iron stores at birth in this prospective cohort study. Overall, 288 term singleton neonates born to women without any complications by CDMR or spontaneous vaginal delivery (SVD) were included.

The investigators measured the following haematological iron-related indicators in cord blood: serum ferritin (SF), haemoglobin (Hb), red blood cell (RBC), and haematocrit (Hct). They also measured blood flow volume of cord vein when clamping to reflect placental transfusion status during birth. Finally, the association between delivery mode and iron store indicators was assessed using quantile regression.

Women in the CDMR group (n=154) had lower conditional median cord blood SF (–34.80 μg/L, 95 percent confidence interval [CI], –64.70 to –4.90; p=0.02), Hb (–10.67 g/L, 95 percent CI –18.87 to –2.47; p=0.01), RBC (–0.30 ×10¹²/L, 95 percent CI, –0.48 to –0.12; p=0.002), and Hct (–3.06 percent, 95 percent CI, –6.08 to –0.04; p=0.047) than those in the SVD group (n=134).

The blood flow volume was also higher in the CDMR group than the SVD group at the 25th centile (0.51 mg/cm³, 95 percent CI, 0.19–0.82; p=0.001), median (0.49 ml/cm³, 95 percent CI, 0.04–0.95; p=0.03), and the 75th centile (0.54 ml/cm³, 95 percent CI, 0.06–1.03; p=0.03).