THE INFLUENCE OF MATERNAL HEMOGLOBIN AND FERRITIN ON MID-PREGNANCY PLACENTAL VOLUME

Objective To investigate whether low maternal haemoglobin and ferritin levels are associated with increased placental volume by mid-pregnanc y. Design Prospective study of women attending hospital for shared ant enatal care. Setting A teaching hospital in the south of England. Subj ects Five hundred and sixty-eight women booking for delivery in the ho spital. Main outcome measures Placental volume measured by ultrasound at 18 weeks gestation. Results At 14 weeks gestation 9% of women had h aemoglobin levels less than or equal to 11 g/dl and 26% had ferritin l evels < 13 mu g/l. Placental volume at 18 weeks was inversely related to the maternal haemoglobin and ferritin levels. The influence of haem oglobin and ferritin concentrations was independent of maternal social class, parity, smoking, and weight. Larger placentae were found in ta ller women, those who had previously been pregnant, and in those who w ere smoking more than 15 cigarettes daily at the time of their last me nstrual period. Conclusion These data suggest that placental developme nt is influenced from early in pregnancy by the intrauterine environme nt provided by the mother. In conjunction with other studies they supp ort the proposal that, as a result of these changes, programming of ad ult blood pressure may be initiated in early pregnancy.