TABLE 4.
Infant iron status measures among 6.5-month FASD diagnostic groups
| Controls | Exposed nonsyndromal | PFAS | FAS | Post hoc FAS vs. controls | |||
|---|---|---|---|---|---|---|---|
| M1 (95% CI) | M1 (95% CI) | M1 (95% CI) | M1 (95% CI) | P 1 | Mean difference1 (95%CI) | P 1 | |
| Neonatal period | n = 57 | n = 73 | n = 6 | n = 19 | — | ||
| Ferritin,2–4 ug/L | 163.0 (147.4–199.3) | 199.3 (180.4–243.7) | 269.4 (163.0–444.9) | 243.7 (180.4–329.3) | 0.108 | 80.7 (5.6–168.5) | 0.046 |
| Hemoglobin,4–7 g/dL | 15.2 (14.7– 15.7) | 15.2 (14.8–15.7) | 13.9 (12.0–15.7) | 15.1 (14.2– 15.9) | 0.581 | −0.1 (−1.1 to 0.9) | 0.856 |
| Hemoglobin:log(ferritin) 3–5 | 3.0 (2.9–3.1) | 2.9 (2.7–3.0) | 2.5 (2.0–3.0) | 2.8 (2.5–3.0) | 0.091 | −0.2 (−0.5 to 0.1) | 0.097 |
| 6.5 months | n = 68 | n = 81 | n = 7 | n = 25 | — | ||
| Ferritin,2–4,6 ug/L | 21.2 (17.2–23.5) | 21.2 (19.1–26.1) | 26.1 (15.4–49.4) | 12.5 (9.0–17.2) | 0.011 | −8.7 (−12.2 to −2.2) | 0.009 |
| sTfR,3,4,6,8–12 mg/L | 6.1 (5.6–6.6) | 5.9 (5.5–6.3) | 6.1 (4.6–7.7) | 6.6 (5.7–7.5) | 0.498 | 0.5 (−0.5 to 1.6) | 0.316 |
| sTfR:log(ferritin) 3,4,6,11,13 | 2.3 (1.9–2.6) | 2.1 (1.8–2.4) | 1.7 (0.6–2.7) | 3.2 (2.6–3.7) | 0.009 | 0.9 (0.2–1.6) | 0.010 |
| Hemoglobin,3–6,9–11,14 g/dL | 10.8 (10.6–11.1) | 10.6 (10.4–10.9) | 10.5 (9.5–11.5) | 10.3 (9.9–10.8) | 0.343 | −0.5 (−1.0 to 0.1) | 0.081 |
| Hemoglobin:log(ferritin) 3–6 | 3.7 (3.5–4.0) | 3.7 (3.4–3.9) | 3.3 (2.2–4.4) | 4.2 (3.7–4.6) | 0.198 | 0.4 (0.1–1.0) | 0.104 |
| Anemia | — | — | — | — | 0.01015 | — | |
| No anemia, hemoglobin ≥11 g/dL | 35 (51.5) | 38 (48.1) | 2 (28.6) | 9 (36.0) | — | ||
| Moderate, 8.5 ≤ hemoglobin <11 g/dL | 28 (41.2) | 34 (43.0) | 3 (42.9) | 9 (36.0) | — | ||
| Severe, hemoglobin <8.5 g/dL | 5 (7.4) | 7 (8.9) | 2 (28.6) | 7 (28.0) | — | ||
| Iron deficiency,16 | — | — | — | — | 0.00215 | — | |
| Iron sufficient | 28 (63.6) | 28 (60.9) | 2 (5.0) | 7 (33.3) | — | ||
| Iron deficiency without anemia | 7 (15.9) | 10 (21.7) | 0 (0.0) | 2 (9.5) | — | ||
| Iron deficiency with anemia | 9 (20.5) | 8 (17.4) | 2 (50.0) | 12 (57.1) | — | ||
| Anemia of inflammation16 | 8 (15.7) | 14 (23.0) | 2 (33.3) | 1(4.5) | 0.35515 | — | |
Abbreviations: FAS, fetal alcohol syndrome; FASD, fetal alcohol spectrum disorders; PFAS, partial fetal alcohol syndrome; sTfR, soluble transferrin receptor.
From ANCOVA models. Potential covariates included factors known to affect maternal iron status (age, gravidity, cigarette smoking, average daily dietary iron intake, iron supplementation, household food insecurity (53)), prenatal methamphetamine use, gestational hypertension, age at time of blood draw; for 6.5-month outcome models, weeks breastfeeding, weeks formula feeding, and weeks giving complementary foods were each considered as well. Covariates were included if their removal from an ANCOVA model including all potential covariates for a given outcome resulted in a change in the partial eta-squared value for FASD diagnostic group by >10%. Given the rapid changes in erythrocytes and ferritin that occur in the first few weeks of life (55), age at time of assessment was included in all neonatal outcome models.
Values are antilog − 1 of estimates from models using logged values due to skewness (>3.0).
Maternal prenatal methamphetamine use (days/mo) was included in ANCOVA models.
Age at time of blood draw was included in ANCOVA models.
Food insecurity was included in ANCOVA models.
Maternal gestational hypertension was included in ANCOVA models.
Prenatal iron supplementation (yes = 1, no = 0) was included in ANCOVA models.
Maternal age was included in ANCOVA models.
Gravidity was included in ANCOVA models.
Dietary iron intake (mg/day) was included in ANCOVA models.
Weeks gestation at delivery was included in ANCOVA models.
Weeks infant breastfed was included in ANCOVA models.
Weeks infant fed formula was included in ANCOVA models.
Prenatal cigarettes/d was included in ANCOVA models.
Linear-by-linear association.
Those with anemia of indeterminate cause were excluded.