Maternal and cord blood parameters are associated with placental and newborn outcomes in indigenous mothers: A case study in the MINDI cohort
Abstract
Background:Multiple infections, nutrient deficiencies and inflammation (MINDI) occur in indigenous communities, but their associations with perinatal outcomes have not been described.
Objective:To assess maternal and cord blood micronutrient and inflammation status in peripartum mothers from the Ngäbe-Buglé comarca in Panama, and their associations with placental and infant outcomes.
Methods:In 34 mother-newborn dyads, placental weight and diameter were measured, and maternal and cord blood were processed for complete cell counts, serum C-reactive protein, ferritin, serum transferrin receptor (sTfR), vitamins A and D. Blood volumes were calculated using Nadler’s formula.
Results:Mothers had low plasma volume (<2.8 L, 96%), vitamin A (52.9%), vitamin D (29.4%), iron (58.8%) and hemoglobin (23.5%), but high hematocrit (>40%, 17.6%) and inflammation (C-reactive protein >8.1 mg/L, 85.3%). Birthweights were normal, but the low placental weight (35.3%), low head circumference Z-scores (17.6%), and low cord hemoglobin (5.9%), iron (79.4%), vitamin A (14.7%) and vitamin D (82.3%) were identified. Maternal and cord vitamin D were highly correlated. Higher maternal plasma volume was associated with heavier placentae (β= 0.57), and higher cord D (β= 0.43) and eosinophils (β= 0.43) with larger placentae. Hemoconcentration (higher cord hematocrit) was associated with lower newborn weight (β= -0.48) and head circumference (β= -0.56). Inflammation [higher maternal neutrophils (β= -0.50), and cord platelets (β= -0.32)] was associated with the lower newborn length and head circumference.
Conclusion:Maternal-newborn hemoconcentration, subclinical inflammation and multiple nutrient deficiencies, particularly neonatal vitamin D deficiency, were identified as potential targets for interventions to improve pregnancy outcomes in vulnerable communities.
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Keywords
- indigenous population
- cord blood
- plasma volume
- vitamin D
- transferrin receptors
- blood platelets
- Midwifery
- Food Insecurity
- Vulnerable Populations
Author Biographies
, McGill University (Macdonald Campus), School of Human Nutrition, Faculty of Agricultural and Environmental Sciences. Ste-Anne-de-Bellevue, Canada
, McGill University (Macdonald Campus), School of Human Nutrition, Faculty of Agricultural and Environmental Sciences. Ste-Anne-de-Bellevue, Canada
, McGill University (Macdonald Campus), School of Human Nutrition, Faculty of Agricultural and Environmental Sciences. Ste-Anne-de-Bellevue, Canada
, Ministerio de Salud, Departamento de Salud Nutricional, Ciudad de Panamá, Panamá
https://orcid.org/0000-0002-0271-1864
, Ministerio de Salud, Región de Salud “Panamá Norte”, Ciudad de Panamá, Panamá
, Ministerio de Salud, Región de Salud “Comarca Ngäbe-Buglé” San Félix, provincia de Chiriquí, Panamá
, Universidad de Panamá, Departamento de Bioquímica, Ciudad de Panamá, Panamá
, McGill University (Macdonald Campus), Institute of Parasitology, Faculty of Agricultural and Environmental Sciences. Ste-Anne-de-Bellevue, Canada
, McGill University (Macdonald Campus), School of Human Nutrition, Faculty of Agricultural and Environmental Sciences. Ste-Anne-de-Bellevue, Canada
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