What is the influence of chronic maternal prenatal stress (PS) on fetal iron homeostasis? In a prospective case-control study in 164 pregnant women, we show that cord blood transferrin saturation is lower in male stressed neonates. The total effect of PS exposure on fetal ferritin revealed a decrease of 15.4% compared with controls. Electrocardiogram-based Fetal Stress Index (FSI) identified affected fetuses non-invasively during the third trimester of gestation. FSI-based timely detection of fetuses affected by PS can support early individualized iron supplementation and neurodevelopmental follow-up to prevent long-term sequelae due to PS-exacerbated impairment of the iron homeostasis.
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