Iron requirement in normal pregnancy as assessed by serum ferritin, serum transferrin saturation and erythrocyte protoporphyrin determinations

Abstract

Summary. Serum iron, serum iron‐binding capacity, serum ferritin and erythrocyte protoporphyrin were determined during uncomplicated pregnancy in 45 healthy women; 22 were given oral iron while the others were given a placebo. When iron was not given, 15 out of 23 women had exhausted iron stores and iron deficiency at term, as judged from low serum ferritin, low serum transferrin saturation and high erythrocyte protoporphyrin values. Only seven of them had a haemoglobin concentration between 10 and 11 g/dl at term but none had values < 10 g/dl. In the iron‐treated group (n=22) none of the women developed iron deficiency. Serum ferritin was the most sensitive and specific test of iron deficiency. A practical procedure to detect iron deficiency and to control iron supplementation in pregnancy is suggested.

Is adequate and balanced nutrition during pregnancy more effective than iron and folic acid supplements?

“…With respect to the startup values, the only factor that showed a statistically significant increase was serum ironbinding capacity. No statistically significant difference could be determined in other parameters [29]. In the present study, serum iron and ferritin levels showed a statistically significant reduction in Group I (p<0.01).…”

“…It was determined that serum ferritin, iron level, and hemoglobin concentration decreases as pregnancy progresses in women who are not anemic and who do not take an iron supplement, even if adequate and balanced nutrition is provided [26,27]. Some studies have reported cases where, even if the pregnant patient was well nourished, the iron requirement could not be met without additional iron supplementation [28,29]. It has been established that patients who are not anemic at the start of their pregnancy and who are not given supplementary iron show normal iron levels 2 years after giving birth.…”

“…The recovery process of some patients who were unable to access sufficient iron might have taken longer because of poor nutrition. In such cases, supplementary iron was essential [29]. Although it is recommended that pregnant women take iron supplements because iron sources are inadequate and maternal iron depots are unreliable, there is a view in the literature that iron absorbency increases parallel to the increasing iron requirement, so the requirement is then met naturally.…”

Anaemia in pregnancy—a cross-sectional study in Singapore

“…Women who had anaemia in previous pregnancies tend to have persistent anaemia in the next pregnancy (Fleming et al, 1974), their low haemoglobin values being associated with low birthweight in the current pregnancy. Most women have inadequate iron stores to start with when they embark upon a new pregnancy (Puolakka et al, 1980;Romslo et al, 1983) and when their iron stores become deplete at the end of their pregnancy, they often do not have time to replenish their stores, which may take more than a year to return to prepregnancy levels (Letsky, 1995). The situation is made even worse with multiparity, and when the interval between pregnancies is too close for the women to recover her iron stores.…”

Correlation of haemoglobin and red cell indices with serum ferritin in Indian women in second and third trimester of pregnancy

“…Also, even with iron deficiency, serum iron can be high or normal if the pregnant female is on oral iron. 10 The estimation of ferritin is expensive and cannot be routinely done in all, thus there is a need for surrogate markers to identify women who need iron supplementation. It is also necessary to determine the usefulness of red cell indices in diagnosing iron deficiency anaemia as well as subclinical iron deficiency longitudinally during the course of pregnancy.…”