Serum Iron Concentration of Maternal and Umbilical Cord Blood during Pregnancy

임신기 모체 혈청과 신생아 제대혈청의 철분함량

  • Jang, Hey-Mi (Department of Food & Nutrition, Sungshin Women's University) ;
  • Ahn, Hong-Seok (Department of Food & Nutrition, Sungshin Women's University)
  • 장혜미 (성신여자대학교 식품영양학과) ;
  • 안홍석 (성신여자대학교 식품영양학과)
  • Published : 2005.12.01

Abstract

Anemia diagnosed early in pregnancy is associated with increased risks of low birth weight and preform delivery. The purposes of this study were to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal-umbilical cord serum iron and ferritin levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum iron and ferritin levels in maternal blood and umbilical cord were measured at 1st-, 2nd-, 3rd- trimester and delivery, respectively. The mean of maternal se겨m iron levels of the trimester and delivery were $124.27\;{\mu}g/dl,\;97.03\;{\mu}g/dl,\;94.32\;{\mu}g/dl,\;and\;145.53\;{\mu}g/dl$. Those maternal levels were significantly lower than that of umbilical cord blood ($222.59\;{\mu}g/dl$). Serum ferritin levels of maternal trimester and delivery were 22.68 $22.68\;{\mu}g/l,\;11.09\;{\mu}g/l,\;14.18\;{\mu}g/l,\;and\;\;24.54\;{\mu}g/l$, which were significantly lower than those of umbilical cord blood ($184.35\;{\mu}g/l$) (p < 0.0001). This prevalence of anemia of total subjects was $30.3\%$ by WHO criteria (Hb < 11.0 g/dl, Hct < $33\%$). Iron levels of 2nd-trimester was significantly higher in the normal group than in the anemia group. And ferritin levels of 3rd-trimester and delivery was significantly higher in the normal group than in the anemia group. Therefore, we suggest for successful pregnancy outcome and delivery differential iron supplementation programs will be carried out with individual Pregnant women on the basis of pre-Pregnancy nutrition. (Korean J Community Nutrition 10(6) : $860\∼868$, 2005)

Keywords

References

  1. Ahn HS, Kim JS, Lee GJ, Kim YT (2000): Serum Folate Levels of Maternal-Umbilical Cord Blood and Pregnancy Outcomes. Korean J Nutrition 33(8): 840-847
  2. Agarwal KN, Agrawal DK, Mishra KP (1991): Impact of anemia prophylaxis in pregnancy on maternal hemoglobin, serum ferritin and birth weight. Indian J Med Res 94: 277-280
  3. Allen LH (2000): Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr 71(suppl): 1280s-1284s
  4. Asima M, Neerja B, Alka K, Ravindra M, Pandey, Renu S (2004): Daily versus intermittent iron supplementation in pregnant women: Hematological and pegnancy outcome. J Obstet Gynaecol Res 30 (6): 409-417 https://doi.org/10.1111/j.1447-0756.2004.00223.x
  5. Bai HY, Lee GS, Lee MS, Lee SY, Shin YM, Ahn HS (2002): Iron status indices of maternal, umbilical cord, placenta and birth weigh. Korea J Community Nutrition 7(5): 686-695
  6. Baron MA, Solano L, Pena E, Del Real S (2005): Iron stores status at early pregnancy. Invest Clin 46(2): 121-130
  7. Barrett JF, Whittaker PG, Williams JG, Lind T (1994): Absorption of non-hem iron from food during normal pregnancy. Br Medical J 309(6947): 79-82 https://doi.org/10.1136/bmj.309.6947.79
  8. Chelchowska M, Laskowska-Klita T (2002): Effect of maternal smoking on some markers of iron status in umbilical cord blood. Rocz Akad Med Bialymst 47: 235-240
  9. Dallman PR (1989): Review of iron metabolism. In: Filer LJ, ed. Dietary iron: Birth to two years. New York: Raven Press, pp.1-18
  10. Dawson EB, Mc Ganity WT (1987): Protection of iron stores in pregnancy. J Repor Med 62(suppl): 478-487
  11. DeMaeyer E, Adiels-Tegman M (1985): The prevalence of anemia in the world. Wld Hlth Statist Quart 38: 302-316
  12. Garn SM, Keatin MT, Falkner F (1981): Hematological status and pregnancy outcomes. Am J Clin Nutr 34: 115 https://doi.org/10.1093/ajcn/34.1.115
  13. Gordenberg RL, Tamura T, DuBard M, Johnston KE, Copper RL, Negers Y (1996): Plasma ferritin and pregnancy outcome. Am J Obstet Gynecol 175: 1356-1359 https://doi.org/10.1016/S0002-9378(96)70054-6
  14. Hibbard JU, Hbbard MC, Ismail M, Arendt E (1993): Pregnancy outcome after expectant management of premature rupture of the membranes in the second trimester. J Reprod Med 38(12): 945-951
  15. Institute of Medicine (1990): Committee on nutritional status during pregnancy and lactation. Nutrition during pregnancy, National Academy Press, Washington DC
  16. Kim EK, Lee KH (1998): Assesment of the intake and availability of dietary iron and nutrition knowledge in pregnant women. Korea J Community Nutrition 3(1): 53-61
  17. Kim EK, Lee KH (1999): Iron status in pregnancy women and their newborn infants. Korea J Nutrition 32(7): 793-801
  18. Klebanoff MA, Shiono PH, Selby JV, Trachtenberg AI, Graubard BI (1991): Anemia and spontaneous preterm birth. Am J Obstet Gynecol 164: 59-63 https://doi.org/10.1016/0002-9378(91)90626-3
  19. Knutson MD, Waler PB, Ames BN, Viteri FE (2000): Both iron deficiency and dail iron supplements increase lipid peroxidation in rat. J Nutr 130: 621-628 https://doi.org/10.1093/jn/130.3.621
  20. Korea Society of nutrition (2005): Dietary Reference Intakes For Koreans
  21. Kurtoglu S, Atabek ME, Gunes T, Akcakus M, Keskin M, Kocaoglu C (2004): Relationship between cord blood levels of IGF-1 and ferritin in healthy term neonates. J Pediatr Endocrinol Metab 17(5): 737-742
  22. Lannotti LL, O'Brien KO, Chang SC, Mancini J, Schulman-Nathanson M, Liu S, Harris ZL, Witter FR (2005): Iron deficiency anemia and depleted body iron reserves are prevalent among pregnant african-american adolescents. J Nutr 135: 2572-2577 https://doi.org/10.1093/jn/135.11.2572
  23. Lee JA, Lee JI, Lim HS (2004): A study on the changes of maternal dietary iron intakes, its bioavailability, and iron status during pregnancy. Korea J Community Nutrition 9(2): 142-150
  24. Lee JI, Lee JA, Lim HS (2005): Effect of time of initiation and dose of prenatal iron and folic acid supplementation on iron and folate nutriture of Korean women during pregnancy. Am J Clin Nutr 82: 843-849 https://doi.org/10.1093/ajcn/82.4.843
  25. Lim HS, Kim HA (1998): Effects of maternal anemia on the iron status of the cord blood and pregnancy outcomes. Korea J Community Nutrition 3(4): 565-573
  26. Linder MC, Munro HN (1977): The mechanism of iron absorption and its regulation. Fed Proc 36: 2017-2023
  27. Lu ZM, Goldenberg RL. Cliver SP, Cuter G, Blankson M (1991): The relationship between maternal hematocrit and pregnancy outcome. Obstet Gynecol 77: 190-194 https://doi.org/10.1097/00006250-199102000-00005
  28. Maria JG, Rosa O (1993): Relationship between iron status in pregnant women and their newborn babies. Acta Obst Gyne Scan 72: 534- 537 https://doi.org/10.3109/00016349309058158
  29. Milman N, Ibsen KK, Christensen JM (1987): Serum ferritin and iron status in mothers and newborn infants. Acta Obst Gyne Scan 66: 205-211 https://doi.org/10.3109/00016348709020748
  30. Murphy JF, O'Riordan J, Newcombe RJ, Coles EC, Pearson JF (1986): Relation of hemoglobin levels in first and second trimesters to outcome of pregnancy. Lancet 1: 992
  31. National Research Council (US)(1989): Committee on diet and health. Diet and health: implications for reducing chronic disease risk. Washington, DC: National Academy Press
  32. Picciano MF (1996): Pregnancy and Lactation. Present knowledge in nutrition 7th edition In: 37. International Life Sciences Institute - Nutrition Foundation ILSI Press, Washington, D.C. pp.390-401
  33. Rasnussen KM (2001): Is there a causal relationship between iron deficiency of iron-deficiency anemia and weight at birth, length of gestation and perinatal motality. J Nutr 131: 590s-603s https://doi.org/10.1093/jn/131.2.590S
  34. Rondo PH, Abbot R, Rodrigues LC, Tomkins AM (1997): The influence of maternal nutritional factor of intrauterine growth retardation in Brazil. Paediatr Perinat Epidemiol 11: 152-166 https://doi.org/10.1046/j.1365-3016.1997.d01-16.x
  35. Scholl TO, Hediger ML (1994): Anemia and iron-deficiency anemia: a complication of data on pregnancy outcome. Am J Clin Nutr 59 (suppl): 492s-501s https://doi.org/10.1093/ajcn/59.2.492S
  36. Scholl TO (2005): Iron status during pregnancy): setting the stage for mother and infant. Am J Clin Nutr 81(suppl): 1218s-1222s https://doi.org/10.1093/ajcn/81.1.218S
  37. Scholl TO, Reilly TM (2000): Anemia, iron and pregnancy outcome. J Nutr Fed 130(2S suppl): 443s-447s https://doi.org/10.1093/jn/130.2.443S
  38. Steer PJ (2000): Maternal hemoglobin concentration and birth weight. Am J Clin Nutr 71(suppl): 1285s-1287s https://doi.org/10.1093/ajcn/71.1.285s
  39. Stekel PJ (1984): Iron requirements in infancy and childhood. In: Iron nutrition in infancy and childhood. New York: Raven Press. pp.1- 10
  40. Taylor DJ, Mallen C, McDougall N, Lind T (1982): Effect of iron supplementation on serum ferritin levels during and after pregnancy. Br J Obstet Gynecol 89: 1011-1017 https://doi.org/10.1111/j.1471-0528.1982.tb04656.x
  41. Ursell B (2005): Management of iron deficiency in pregnancy. RCM Midwives 8(2): 78-79
  42. Wothington RB, Williams SD (1989): Nutrition in pregnancy and lactation, 4th edition. Times Mirror Mosby College Publishing. St. Louis Mo, pp.36-178
  43. World Health Organization (1968): Nutritional anemia. WHO Tech Rep Ser 406: 1-36
  44. Yu KH, Yoon JS (1998): The effect of weekly iron supplementation on iron and zinc nutritional status in pregnant women. Korea J Nutrition 31(8): 1270-1282
  45. Yu KH, Yoon JS, Hahm YS (1999): A cross-sectional study of bichemical analysis and assessment of iron deficiency by gestational age(II). Korea J Nutrition 32(8): 887-896
  46. Yoon JS, Park JA, Son SM (2003): The iron status and diet quality of pregnant women during the first five months of pregnancy. Korea J Community Nutrition 8(6): 803-813