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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

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Volume 41, Issue 3 (May 2013)


Prenatal maternal stress predicts cord-blood ferritin concentration

Rinat Armony-Sivan
  • Corresponding author
  • Department of Psychology, Ashkelon Academic College, Ashkelon, Israel
  • These authors have contributed equally to this work.
  • Email:
/ Shraga Aviner
  • Department of Pediatrics, The Barzilai Medical Center, Ashkelon, Israel
  • The Faculty of Health Sciences, Ben-Gurion University of the Negev, The Barzilai Medical Center Campus, Ashkelon, Israel
  • These authors have contributed equally to this work.
/ Lutzy Cojocaru
  • Department of Economics, Ashkelon Academic College, Ashkelon, Israel
/ Shlomo Fytlovitch
  • The Faculty of Health Sciences, Ben-Gurion University of the Negev, The Barzilai Medical Center Campus, Ashkelon, Israel
  • Laboratory of Biochemistry, Barzilai Medical Center, Ashkelon, Israel
/ Dora Ben-Alon
  • The Faculty of Health Sciences, Ben-Gurion University of the Negev, The Barzilai Medical Center Campus, Ashkelon, Israel
  • Laboratory of Hematology, Barzilai Medical Center, Ashkelon, Israel
/ Anat Eliassy
  • The Faculty of Health Sciences, Ben-Gurion University of the Negev, The Barzilai Medical Center Campus, Ashkelon, Israel
  • Department of Obstetrics and Gynecology, The Barzilai Medical Center, Ashkelon, Israel
/ Harvey Babkoff
  • Department of Psychology, Ashkelon Academic College, Ashkelon, Israel
/ Betsy Lozoff
  • Center for Human Growth and Development and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA
/ Eyal Anteby
  • The Faculty of Health Sciences, Ben-Gurion University of the Negev, The Barzilai Medical Center Campus, Ashkelon, Israel
  • Department of Obstetrics and Gynecology, The Barzilai Medical Center, Ashkelon, Israel
Published Online: 2012-11-15 | DOI: https://doi.org/10.1515/jpm-2012-0125


Aim: To examine the relationship between maternal stress in early pregnancy and cord-blood ferritin concentration.

Methods: The sample consisted of 140 pregnant women who lived in a region that was under rocket attack during a military operation (December 2008 to January 2009). Mothers in the stress group (n=63) were in their first trimester during this period. Mothers in the control group (n=77) became pregnant 4–5 months after the attacks ended. Maternal subjective stress was reported retrospectively. Cord-blood ferritin concentration was compared between stress and control groups, and was the dependent variable in a hierarchical multiple regression analysis.

Results: The mean cord-blood ferritin concentration was lower in the stress group compared to the control group (145.7±62.0 vs. 169.3±85.4 ng/mL, P<0.05). The cumulative distribution of cord-blood ferritin showed a shift to the left for the stress group. Hierarchical multiple regression analysis revealed that maternal subjective stress was a predictor for cord-blood ferritin concentration (hierarchical regression: β=–0.18, P<0.05), especially in the stress group (simple slope analysis: β=–0.32, P<0.01).

Conclusion: Maternal stress during the first trimester of pregnancy is associated with lower cord-blood ferritin concentration.

Keywords: Cord-blood; ferritin; fetal; iron deficiency; stress; prenatal


  • [1]

    Aiken LS, West SG. Multiple regression: testing and interpreting Interactions. Newbury Park: Sage; 1991.

  • [2]

    Amin SB, Orlando M, Eddins A, MacDonald M, Monczynski C, Wang H. In utero iron status and auditory neural maturation in premature infants as evaluated by auditory brainstem response. J Pediatr. 2010;156:377–81. [Web of Science]

  • [3]

    Armony-Sivan R, Eidelman AI, Lanir A, Sredni D, Yehuda S. Iron status and neurobehavioral development of premature infants. J Perinatol. 2004;24:757–62. [Crossref]

  • [4]

    Barker DJP. Mothers, babies, and health in later life. 2nd ed. Edinburgh: Churchill Livingstone; 1998.

  • [5]

    Beard JL, Erikson KM, Jones BC. Neonatal iron deficiency results in irreversible changes in dopamine function in rats. J Nutr. 2003;133:1174–9.

  • [6]

    Beck AT, Steer RA, Brown GK. Beck Depression Inventory — II. San Antonio: The Psych Corp.; 1996.

  • [7]

    Chen J, Shen H, Chen C, Wang W, Yu S, Zhao M, Li M. The effect of psychological stress on iron absorption in rats. BMC Gastroentrol. 2009;9:1–6.

  • [8]

    Coe CL, Lubach GR. Fetal programming: Prenatal origins of health and illness. Curr Dir Psychol Sci. 2008;17:36–41. [Crossref]

  • [9]

    Coe CL, Lubach GR, Shirtcliff E. Maternal stress during pregnancy increases risk for iron deficiency in infants impacting innate immunity. Pediatr Res. 2007;61:520–4. [Web of Science] [Crossref]

  • [10]

    Connor JR, Menzies SL. Altered cellular distribution of iron in the central nervous system of myelin deficient rats. Neuroscience. 1990;34:265–71. [PubMed] [Crossref]

  • [11]

    Davey HM, Barratt AL, Butow PN, Deeks JJ. A one-item question with a Likert or Visual Analog Scale adequately measured current anxiety. J Clin Epidemiol. 2007;60:356–60. [PubMed] [Web of Science] [Crossref]

  • [12]

    DeUngria M, Rao R, Wobken JD, Luciana M, Nelson CA, Georgieff MK. Perinatal iron deficiency decreases cytochrome c oxidase (CytOx) activity in selected regions of neonatal rat brain. Pediatr Res. 2000;48:169–76. [PubMed] [Crossref]

  • [13]

    Georgieff MK. Long-term brain and behavioral consequences of early iron deficiency. Nutr Rev. 2011;69:S43–8. [Web of Science]

  • [14]

    Georgieff MK, Schmidt RL, Mills MM, Radmer WJ, Widness JA. Fetal iron and cytochrome c status after intrauterine hypoxemia and erythropoietin administration. Am J Physiol. 1992;268:R485–91.

  • [15]

    Georgieff MK, Wewerka SW, Nelson CA, deRegnier RA. Iron status at 9 months of infants with low iron stores at birth. J Pediatr. 2002;141:405–9.

  • [16]

    Gheorghe CP, Goyal R, Mittal A, Longo LD. Gene expression in the placenta: maternal stress and epigenetic responses. Int J Dev Biol. 2010;54:507–23. [Crossref] [PubMed] [Web of Science]

  • [17]

    Hay G, Refsum H, Whitelaw A, Melbye EL, Haug E, Borch-Iohnsen B. Predictors of serum ferritin and serum soluble transferrin receptor in newborns and their associations with iron status during the first 2 y of life. Am J Clin Nutr. 2007;86:64–73.

  • [18]

    Hollingshead AB. Four factor index of social status. New Haven, CT: Yale University; 1975.

  • [19]

    Lozoff B. Early iron deficiency has brain and behavior effects consistent with dopaminergic dysfunction. J Nutr. 2011;141:740S–6S. [Web of Science]

  • [20]

    Lozoff B, Georgieff MK. Iron deficiency and brain development. Semin Pediatr Neurol. 2006;13:158–65. [PubMed] [Crossref]

  • [21]

    Lozoff B, Walter T, Kaciroti N. Iron deficiency in infancy: applying a physiologic framework for prediction. Am J Clin Nutr. 2006;84:1412–21. [PubMed]

  • [22]

    Petry CD, Eaton MA, Wobken JD, Mills MM, Johnson DE, Georgieff, MK. Iron deficiency of liver, heart and brain in newborn infants of diabetic mothers. J Pediatr. 1992;121:109–14. [PubMed] [Crossref]

  • [23]

    Rao R, Georgieff MK. Perinatal aspects of iron metabolism. Acta Paediatr Suppl. 2002;91:124–9. [PubMed]

  • [24]

    Rao R, Georgieff MK. Iron in fetal and neonatal nutrition. Semin Fetal Neonat Med. 2007;12:54–63. [Web of Science]

  • [25]

    Rao R, Tkac I, Townsend EL, Gruetter R, Georgieff MK. Perinatal iron deficiency alters the neurochemical profile of the developing rat hippocampus. J Nutr. 2003;133:3215–21.

  • [26]

    Richter P, Werner J, Heerlein A, Kraus A, Sauer H. On the validity of the Beck Depression Inventory. A review. Psychopathology. 1998;31:160–8.

  • [27]

    Siddappa AM, Georgieff MK, Wewerka S, Worwa C, Nelson CA, deRegnier R-A. Iron deficiency alters auditory recognition memory in newborn infants of diabetic mothers. Pediatr Res. 2004;55:1034–41. [PubMed] [Crossref]

  • [28]

    Siddappa AM, Rao R, Long JD, Widness JA, Georgieff MK. The assessment of newborn iron stores at birth: a review of the literature and standards for ferritin concentrations. Neonatology. 2007;92:73–82. [Web of Science] [Crossref] [PubMed]

  • [29]

    Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1983.

  • [30]

    Stern RA. Visual analog mood scales professional manual. Odessa, FL: Psychological Assessment Resources, Inc.; 1997.

  • [31]

    Tamura T, Goldenberg RL, Hou J, Johnston KE, Cliver SP, Ramey SL, et al. Cord serum ferritin concentrations and mental and psychomotor development of children at five years of age. J Pediatr. 2002;140:165–70.

  • [32]

    Youdim MB, Yehuda S. The neurochemical basis of cognitive deficits induced by brain iron deficiency: involvement of dopamine-opiate system. Cell Mol Biol. 2000;46:491–500.

About the article

Corresponding author: Rinat Armony-Sivan, Department of Psychology Ashkelon Academic College, Ashkelon, 78109 Israel, Tel.: +972 86789273, Fax: +972 86789288

Received: 2012-05-31

Accepted: 2012-10-16

Published Online: 2012-11-15

Published in Print: 2013-05-01

Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2012-0125. Export Citation

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