Absorption of non-haem iron from food during normal pregnancy

Barrett, Jon; Whittaker, Paul; Williams, John G.; Lind, T.

doi:10.1136/bmj.309.6947.79

Cited by 158 publications

(72 citation statements)

References 20 publications

(18 reference statements)

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“…This is probably due to increasing requirement of iron as the pregnancy progresses coupled with the exhaustion of iron stores in most women in the second and third trimesters [22]. …”

Section: Discussionmentioning

confidence: 99%

Factors associated with maternal anaemia among pregnant women in Dhaka city

et al. 2015

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BackgroundMaternal anaemia is a common problem in pregnancy, particularly in developing countries. The study was aimed at determining the factors associated with anaemia among a group of pregnant mothers who attended an antenatal clinic in Dhaka city.MethodsThis cross-sectional study included 224 pregnant women, who visited the antenatal clinic of the Marie Stops, Dhaka. Demographic data and information on maternal age, gestational age, educational and income level, and socioeconomic status were collected from all the subjects. Haemoglobin status was measured to assess their anaemia. A qualified technician drew venous blood samples from them. The reference values of haemoglobin were categorized according to the World Health Organization (WHO) criteria as follows: normal (11 g/dL or higher), mild (10–10.9 g/dL), and moderate (7–9.9 g/dL). Mild and moderate levels of haemoglobin were defined as anaemic (haemoglobin levels of <11 g/dL). The SPSS software (Windows version 16.0. SPSS Inc, Chicago, USA) was used for analyzing data.ResultsThe mean (±SD) age of the subjects was 26.4 ± 2.81 years. Sixty-three percent of the subjects had normal level of haemoglobin, and 37 % were anaemic 26 % mild and 11 % moderate. Maternal anaemia was significantly associated with age (p = 0.036), education (p = 0.002), income (p = 0.001), living area (p = 0.031). Results of binary logistic regression analysis showed that maternal anaemia was also significantly associated with age (p = 0.006), educational status (primary to 8th grade, p = 0.004; secondary and above, p = 0.002), living area (0.022), and income (0.021).DiscussionA significant proportion of pregnant women were found anaemic. Most data showed education has animpact on awareness to use of health services and iron supplementation should be encouraged to improve the haemoglobin levels in pregnancy.ConclusionsThe results indicate that anaemia is alarmingly high among pregnant women in Dhaka city. Maternal anaemia is associated with age, education level, income level, and living area. The results suggest that pregnant women and members of their families should be urgently educated to understand the importance of antenatal care.

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“…This is probably due to increasing requirement of iron as the pregnancy progresses coupled with the exhaustion of iron stores in most women in the second and third trimesters [22]. …”

Section: Discussionmentioning

confidence: 99%

Factors associated with maternal anaemia among pregnant women in Dhaka city

et al. 2015

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“…4 5 Iron absorption is also maximal at this time. For example, in humans, there is a ninefold increase in iron absorption between weeks 12 and 36 of gestation 6 while in rats absorption increases substantially from day 16 through to term at day 21. 1 Absorption rapidly returns to control levels post-partum (for example, within 18 hours in rats), 7 indicating the strength of the absorption stimulus provided by pregnancy.…”

mentioning

confidence: 99%

Changes in the expression of intestinal iron transport and hepatic regulatory molecules explain the enhanced iron absorption associated with pregnancy in the rat

Millard

Frazer²,

Wilkins³

et al. 2004

Gut

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Background: Iron absorption increases during pregnancy to cater for the increased iron requirements of the growing fetus. Aims: To investigate the role of the duodenal iron transport molecules and hepatic regulatory molecules in coordinating the changes in iron absorption observed during pregnancy. Methods: Rats at various days of gestation and 24-48 hours post-partum were examined for hepatic expression of hepcidin, transferrin receptors 1 and 2, and HFE (the gene mutated in the most prevalent form of hereditary haemochromatosis), and duodenal expression of divalent metal transporter 1 (DMT1), duodenal cytochrome b (Dcytb), iron regulated mRNA (Ireg1), and hephaestin (Hp) by ribonuclease protection assay, western blotting, and immunohistochemistry. Results: Decreased hepatic non-haem iron and transferrin saturation and increased expression of transferrin receptor 1 in the liver indicated a progressive reduction in maternal body iron stores during pregnancy. Duodenal expression of the iron transport molecules DMT1, Dcytb, and Ireg1 increased during pregnancy, and this corresponded with a reduction in hepcidin, HFE, and transferrin receptor 2 expression in the liver. Expression of all molecules returned towards control values by 24-48 hours postpartum. Conclusions: These data indicate that increased expression of key iron transport molecules is responsible for the elevated iron absorption associated with pregnancy, and implicate hepcidin, HFE, and transferrin receptor 2 in determining how the maternal iron homeostatic machinery responds to the increased iron demands accompanying gestation.

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“…In the first trimester of pregnancy, the Hb concentration was higher and the prevalence of anemia lower in the weekly group when women had used an estimated average of 29 pink UNILAB tablets (range [23][24][25][26][27][28][29][30][31][32][33] and an average of 5 red UNILAB tablets (range 1-11). In fact, because women were often aware of their pregnancy only after the first gestational month, they probably took more pink-and less red-UNILAB tablets than estimated here.…”

Section: Discussionmentioning

confidence: 99%

Community Mobilization and Social Marketing to Promote Weekly Iron-Folic Acid Supplementation in Women of Reproductive Age in Vietnam: Impact on Anemia and Iron Status

et al. 2008

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The community mobilization and social marketing program promoting a preventive approach of weekly iron-folic acid supplementation in women of reproductive age improved iron status of non-pregnant women in Vietnam. Three to six months of weekly pre-pregnancy supplementation and regular weekly intake of supplements during pregnancy allowed women to achieve good iron and hemoglobin status during the two first trimesters of pregnancy. In the third trimester, iron deficiency and anemia were notably present but low birth weight prevalence was low. This demonstrates the effectiveness and safety of the preventive approach as implemented here to prevent and control iron deficiency and anemia in women of reproductive age before and during pregnancy.

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Absorption of non-haem iron from food during normal pregnancy

Cited by 158 publications

References 20 publications

Factors associated with maternal anaemia among pregnant women in Dhaka city

Factors associated with maternal anaemia among pregnant women in Dhaka city

Changes in the expression of intestinal iron transport and hepatic regulatory molecules explain the enhanced iron absorption associated with pregnancy in the rat

Community Mobilization and Social Marketing to Promote Weekly Iron-Folic Acid Supplementation in Women of Reproductive Age in Vietnam: Impact on Anemia and Iron Status

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