Severe iron deficiency and anemia early in pregnancy can dramatically increase a child’s risk of heart defects, new research suggests.
A team of researchers at the University of Oxford identified a brand new risk factor for congenital heart disease (CHD) using mouse models.
Affecting 12 babies born every day in the UK, coronary artery disease is the most common human birth defect.
Babies with coronary artery disease are born with one or more structural defects caused when the heart does not develop properly in the womb.
However, it’s not always clear why this happens.
Coronary artery disease can be caused by a genetic defect inherited from one or both parents, such as a genetic mutation.
Mutations in these genes can only explain about a third of cases, while more than 100 genes have been linked to individual cases of the disease.
The cause of coronary heart disease in the other two-thirds of cases is often unknown.
In many of these unknown cases, it is most likely caused by the exposure of the embryo to an abnormal environment in the uterus during early pregnancy, according to the researchers.
However, the disease is not detected systematically until after 20 weeks of pregnancy, so it has been difficult to collect data on the physiology of the mother during the first trimester to establish new risk factors for birth defects.
Duncan Sparrow, associate professor at the University of Oxford, principal investigator at the British Heart Foundation (BHF) and principal investigator of the study, said: baby with low birth weight and premature delivery.
“However, we are specifically investigating maternal iron deficiency in the first trimester for the first time, and we show in mice that maternal iron deficiency can cause serious cardiovascular abnormalities in her offspring.”
The researchers say their findings are supported by a 2020 epidemiological study in China that suggests the risk of having a child with coronary heart disease could be tripled in women who have low iron intake early in life. the pregnancy.
Professor Sparrow said: âAnemia is a major global health problem, affecting 20-40% of women of childbearing age, a total of over 500 million people, and half of these are due to to iron deficiency.
âSo if our results are applicable to humans, this may explain why congenital heart disease is relatively common around the world. “
Research also indicates that the risk of coronary heart disease can be significantly reduced if the mother is given iron supplements, as long as it happens very early in the pregnancy before the heart forms in the embryo.
Dr Jacinta Kalisch-Smith, first author of the article, said: âIn humans, the heart forms between the third and the ninth week.
“Our results from the animal study suggest that iron supplementation should probably be given before week three to be effective.
âEven better to take supplements while trying to conceive, because women may not know they are pregnant at such an early stage.
âThis adds more evidence supporting the WHO global health priority of ensuring women of childbearing age are not iron deficient.
“In fact, the WHO recommends that supplementation be started as early as possible and continued throughout pregnancy.”
The research team hopes their findings can be translated into clinical practice to ultimately reduce the birth prevalence of coronary heart disease worldwide.
The research was funded by the British Heart Foundation (BHF).