Absorption of Supplemental Iron During Pregnancy‐a Longitudinal Study With Repeated Bone‐marrow Studies and Absorption Measurements

Abstract

Abstract. Iron absorption, bone‐marrow smears and haematological parameters were repeatedly studied during pregnancy in 50 women. The same studies were repeated two months after delivery. The material was randomly divided into two groups. Twenty‐four women were treated with 200 mg of ferrous iron daily while 26 were given placebo. The iron absorption was measured from radioiron‐labelled test doses of 100 mg ferrous iron in a whole‐body counter with high sensitivity.In the placebo group the iron absorption increased throughout pregnancy from an average of 6.5 % at the 12th week to 14.3 % at the 35th week of gestation. Two months after delivery the absorption was higher than initially. In the iron‐treated group the absorption increased between the 24th and 35th week of gestation from 6.0 to 8.6 %. After delivery 5.5 % of the test dose was absorbed.The haemosiderin iron in the bone‐marrow was mobilized during pregnancy. In the placebo group no woman had more than trace of haemosiderin in the bone‐marrow smears at the 35th week of gestation. In the iron‐treated group 65 % had the same bone‐marrow findings. The amount of bone‐marrow haemosiderin at term seems not to have the same significance for the diagnosis of iron deficiency in pregnancy as in non‐pregnant subjects. Two months after delivery about 50 % of the women in the placebo group had restored their iron depots. In the iron‐group the haemosiderin content in the bone‐marrow smears was enhanced in most women compared to early pregnancy. In the placebo group haematoLogical data indicated a high frequency of iron deficiency in late pregnancy while in the iron‐treated group iron deficiency was prevented.

A traditional beverage prevents iron deficiency in African women of child bearing age

“…Supplementation with iron tablet is most often used in pregnant women and has been applied with some success to other vulnerable groups (Svanberg et al, 1975). The impact of supplementation on the iron nutrition of a population depends on the adequacy of the health services and, even under optimal conditions, there is imperfect patient compliance (Bonnar & Goldberg, 1969).…”

The prevalence of anaemia depends on the definition: an example from the Aboriginal Birth Cohort Study

“…Among pregnant women, Hb concentration and Hct decline during the first and second trimesters because of an expanding blood volume (18,(39)(40)(41)(42). Among pregnant women who do not take iron supplements, Hb concentration and Hct remain low in the third trimester, and among pregnant women who have adequate iron intake, Hb concentration and Hct gradually rise during the third trimester toward the prepregnancy levels (39,40 ).…”

“…Evidence from randomized control trials indicates that iron supplementation decreases the incidence of iron-deficiency anemia during pregnancy (10,(39)(40)(41)(42), but trials of the effect of universal iron supplementation during pregnancy on adverse maternal and infant outcomes are inconclusive (10,43,44 ).…”

“…Among pregnant women who do not take iron supplements, Hb concentration and Hct remain low in the third trimester, and among pregnant women who have adequate iron intake, Hb concentration and Hct gradually rise during the third trimester toward the prepregnancy levels (39,40 ). Because adequate data are lacking in the United States, the cutoff values for anemia are based on clinical studies of European women who had taken iron supplementation during pregnancy (39)(40)(41)(42)72 ). For pregnant women, a test *Age-and sex-specific cutoff values for anemia are based on the 5th percentile from the third National Health and Nutrition Examination Survey (NHANES III), which excluded persons who had a high likelihood of iron deficiency by using the same methods described by Looker et al (45 ).…”

“…For pregnant women, a test *Age-and sex-specific cutoff values for anemia are based on the 5th percentile from the third National Health and Nutrition Examination Survey (NHANES III), which excluded persons who had a high likelihood of iron deficiency by using the same methods described by Looker et al (45 ). Maximum values for anemia during pregnancy are based on values from pregnant women who had adequate iron supplementation (39)(40)(41)(42)72 ). † Although no data are available from NHANES III to determine the maximum hemoglobin concentration and hematocrit values for anemia among infants, the values listed for children aged 1-<2 years can be used for infants aged 6-12 months.…”