Because iron is critical for fetal development, the fetus produces hormones to regulate iron availability.  A newly identified hormone, erythroferrone (ERFE), as well as erythropoietin (EPO), and hepcidin are involved in the regulation of iron and erythropoiesis.  Existing data document fetal production of EPO and hepcidin, but little is known about ERFE in newborns.  Delaney and colleagues conducted a study designed to determine ERFE concentrations and how they relate to iron status at birth.  The results of their study are published in the September 2021 issue of The Journal of Nutrition.

Subjects in this study were participants in two cohorts (women carrying multiples or teens) with newborns at higher risk of neonatal anemia.  Concentrations of cord blood ERFE, iron regulator hormones and iron status biomarkers were determined at birth.

Cord ERFE was present in all newborns, was lower in newborns from black mothers as opposed to those of white ancestry, and was associated with transferrin receptor, ferritin, and hemoglobin.  Most of the variability in newborn iron and hematologic status was explained by cord concentrations of hepcidin and the ratio of hepcidin to erythropoietin.  The authors concluded that neonatal cord iron status and erythropoietic demand led to the production of ERFE, but it did not explain a significant amount of the variability in newborn iron or hemoglobin concentrations.

In a commentary, Kling describes the critical nature of iron for fetal development, and further makes the point that iron deficiency is a neurocognitive and behavioral risk factor.  Kling suggests the observations of Delaney and colleagues contribute to defining future directions for maternal and fetal iron metabolism research to identify approaches to mitigate the impacts of iron deficiency on neonates.


Delaney KM, Guillet R, Pressman EK, Ganz T, Nemeth E, O’Brien KO.  Umbilical cord erythroferrone is inversely associated with hepcidin, but does not capture the most variability in iron status of neonates born to teens carrying singletons and women carrying multiples.  Journal of Nutrition, Volume 151, Issue 9, September 2021, Pages 2590–2600,

Kling PJ. Ironing out the details of maternal-fetal iron trafficking:  New tools in the toolbox.  Journal of Nutrition, Volume 151, Issue 9, September 2021, Pages 2509–2510,

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