The Influence of Nutritional Supplementation for Iron Deficiency Anemia on Pregnancies Associated with SARS-CoV-2 Infection

Abstract

Anemia is a very common occurrence during pregnancy, with important variations during each trimester. Anemia was also considered as a risk factor for severity and negative outcomes in patients with SARS-CoV-2 infection. As the COVID-19 pandemic poses a significant threat for pregnant women in terms of infection risk and access to care, we developed a study to determine the impact of nutritional supplementation for iron deficiency anemia in correlation with the status of SARS-CoV-2 infection. In a case-control design, we identified 446 pregnancies that matched our inclusion criteria from the hospital database. The cases and controls were stratified by SARS-CoV-2 infection history to observe the association between exposure and outcomes in both the mother and the newborn. A total of 95 pregnant women were diagnosed with COVID-19, having a significantly higher proportion of iron deficiency anemia. Low birth weight, prematurity, and lower APGAR scores were statistically more often occurring in the COVID-19 group. Birth weight showed a wide variation by nutritional supplementation during pregnancy. A daily combination of iron and folate was the optimal choice to normalize the weight at birth. The complete blood count and laboratory studies for iron deficiency showed significantly decreased levels in association with SARS-CoV-2 exposure. Puerperal infection, emergency c-section, and small for gestational age were strongly associated with anemia in patients with COVID-19. It is imperative to screen for iron and folate deficiency in pregnancies at risk for complications, and it is recommended to supplement the nutritional intake of these two to promote the normal development and growth of the newborn and avoid multiple complications during pregnancy in the COVID-19 pandemic setting.

Suboptimal Consumption of Relevant Immune System Micronutrients Is Associated with a Worse Impact of COVID-19 in Spanish Populations

“…Moreover, recent evidence shows that the suboptimal nutritional status of folate and its relationship with COVID-19 could be a point of attention, especially in pregnant women [ 63 ]. Thus, although compliance with dietary recommendations of folate (or supplementation) in pregnancy is essential to promote normal newborn development [ 64 ], this need would result in an increase in the scenario of the COVID-19 pandemic. In this sense, ensuring optimal nutritional levels of folate during pregnancy would be a protective factor for pregnant women against COVID-19, but also for the newborn.…”

Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection

“…Magnesium is the fourth most abundant mineral in the human body, behind calcium, sodium, and potassium, and the second most abundant intracellular cation following potassium [ 25 ]. As a micronutrient, it is involved in multiple functions of the human organism, including immunity.…”

Examining the Birth Weights of Children in India: Impact of Iron-Folic Acid Supplements during Pregnancy

“…Globally more than 20 million infants are born with low birth weight and India alone produces almost forty percent of all Lower Birth Weight (LBW) children born in developing countries (1) . Low birth weight has adverse health consequences including neonatal mortality, morbidity, many chronic diseases in later life as well (2)(3)(4)(5)(6)(7)(8)(9) .…”

“…Public health intervention like micronutrient supplementation during pregnancy in many countries have shown positive impact on infant birth weight and early development in childhood (2)(3)(4)(5)(6)(7) .…”

“…The Iron-Folic acid (IFA) intervention during pregnancy has been reported to be vital determinant of birth weight (2,3,8,9) . As per the national guidelines, pregnant women should take IFA tablets daily for at least 100 days (10) .…”