Serum ferritin, total plasma ferritin and haematological indices were determined during and for 6 months after normal pregnancy in 45 healthy women, 21 of whom took oral iron supplements. The physiological effect of pregnancy was to markedly depress serum ferritin concentration. During unsupplemented pregnancy median serum ferritin concentration decreased to approx. 6.0 pg/l by 28 weeks gestation, this concentration was maintained until term and was associated with the appearance of erythrocyte microcytosis during the third trimester. At 6 months postpartum, individual and average serum and total plasma ferritin values showed a deficit compared with the values recorded at the beginning of pregnancy. Oral iron supplementation during pregnancy modified the fall in serum ferritin, median serum ferritin concentrations remained about 14.0 Fg/1 after 28 weeks gestation; normocytic erythropoiesis was maintained throughout the third trimester and no deficit in serum and total plasma ferritin occurred as a result of pregnancy. It is concluded that routine oral iron administration should be recommended during pregnancy, certainly after 28 weeks gestation.During pregnancy, iron is required for the developing fetus, placenta and increasing maternal erythrocyte mass in addition to the normal daily requirements of a non-pregnant woman. The ability of a pregnant woman to meet these extra demands will depend on her dietary *Present address: Senior Lecturer,
Serum ferritin, measured by radioimmunoassay, was studied in a population of 154 women of reproductive age and during a menstrual cycle in a group of 22 women. Serum ferritin concentrations ranged from 4.7 to 169 pg/1 (median 2 1' 3 yg/l). Recent childbirth was associated with low serum ferritin values, whereas oestrogen/progestogen oral contraception and normal menstruation appeared to have little effect. In the absence of iron supplements, it appears to take up to 2 years after pregnancy before pre-pregnancy serum ferritin values are regained.
Haematological indices and serum ferritin were measured for 6 months in 20 healthy non-pregnant women, nine of whom took oral iron supplements. Whereas the mean serum ferritin concentration increased from 16.2 pg/1 to 41.7 pg/l during oral iron supplementation, the mean haemoglobin concentration remained unchanged at 13.5 g/dl. No stimulatory action of iron on erythropoiesis could be demonstrated.
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