Depleted iron stores without anaemia early in pregnancy carries increased risk of lower birthweight even when supplemented daily with moderate iron
Depleted iron stores without anaemia early in pregnancy carries increased risk of lower birthweight even when supplemented daily with moderate iron
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DOI：
10.1093/humrep/des026
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发表时间：
2012-05-01
影响因子：
6.1
通讯作者：
Arija, V.
中科院分区：
文献类型：
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作者：
Ribot, B.;Aranda, N.;Arija, V.
妊娠期缺铁性贫血有不良妊娠结局。产前补铁对贫血妇女是有益的，但对非贫血妇女的影响是有争议的。根据西班牙卫生部的指导方针，本观察性研究评估了妊娠第812周时孕妇铁储备（耗尽或未耗尽）与出生体重的关系。对205名健康、无贫血的孕妇进行了研究。在第一次产前检查时，进行了一般临床评估，并采集了基础血。将女性分为未耗尽或耗尽铁储备[血清铁蛋白（SF） 12 g/l]。每日产前铁补充剂（平均48毫克）在17周（范围：1618周）开始。测定各妊娠期血红蛋白、SF、转铁蛋白饱和度（TS）。在研究样本中，20人、54人和66人分别在妊娠早期、中期和晚期服用了12克/升的SF。在妊娠晚期，铁缺乏（SF 12 g/l）和铁缺乏（SF 12 g/l和TS 16）的发生率高于未缺铁的妇女（分别为81.6和73.7比61.7和55.4,P < 0.05）。在调整混杂变量后，初始铁缺乏的妇女分娩的婴儿平均比初始铁储存的妇女分娩的婴儿重192克（P = 0.028）。怀孕开始时，铁储备未耗尽，对怀孕期间母亲的铁状态和婴儿出生体重有益。这些研究结果重申了健康促进的重要性，即确保妇女在怀孕前或怀孕早期有足够的铁储备，并补充适量的每日铁剂量。
Gestational iron-deficiency anaemia has adverse pregnancy outcomes. Antenatal iron supplementation can be beneficial in anaemic women, but the effects in non-anaemic women are controversial. This observational study assessed the relationship of maternal iron stores (depleted or non-depleted) at gestational Weeks 812 with birthweight, in non-anaemic pregnant women following the guidelines of the Ministry of Health of Spain.Healthy, non-anaemic pregnant women (n 205) were studied. At the first antenatal visit, a general clinical assessment was conducted, and basal blood taken. Women were classified as having non-depleted or depleted iron stores [serum ferritin (SF) 12 g/l)]. Daily antenatal iron supplements (48 mg on average) were started at 17 (range: 1618) weeks. Blood haemoglobin, SF and transferrin saturation (TS) were measured in each trimester.Of the study sample, 20, 54 and 66 had SF 12 g/l in the first, second and third trimesters, respectively. The prevalence of iron-depletion (SF 12 g/l) and iron-deficiency (SF 12 g/l and TS 16) was greater during the entire pregnancy in women with initial iron depletion versus no depletion (81.6 and 73.7 versus 61.7 and 55.4, respectively, in the third trimester, P 0.05). Women with initial iron-depletion delivered babies weighing on average 192 g less than that with initial iron stores, after adjusting for confounding variables (P 0.028).Beginning pregnancy with non-depleted iron stores is beneficial for the maternal iron status during pregnancy and infant birthweight. These findings reaffirm the importance of health promotion to ensure that women have adequate iron stores prior to, or early in, pregnancy when supplemented with moderate daily iron doses.