Kubik Paweł, Leibschang Jerzy, Kowalska Bozena, Laskowska-Klita Teresa, Stanisławska Anna, Chełchowska Magdalena, Maciejewski Tomasz
Instytut Matki i Dziecka 00-189 Warszawa ul. Kasprzaka 17A, Klinika Połoznictwa i Ginekologii.
Ginekol Pol. 2010 May;81(5):358-63.
AIM OF THE STUDY: The aim of this study was to evaluate the iron status markers in normal healthy pregnancy as well as the influence of maternal diet on iron concentration in their newborns. MATERIAL AND METHODS: A longitudinal prospective study was conducted in a sample of 69 healthy non-smoking pregnant women under prenatal care of The Institute of Mother and Child. Blood samples were collected in the first, second and third trimesters and from the umbilical vein. Concentrations of ferritin and transferrin were assessed using turbidimetric technique, the concentration of iron--with ferrozine colorimetric method. Pentra 120 analyzer was used to define hematological parameters. Maternal diet was assessed by means of a weekly questionnaire, processed with computer software Dietetyk 2. RESULTS: Hematological parameters in the analyzed blood were normal. The average hematocrit values in the first trimester of pregnancy was 36.7%, in the second--34.92%, in the third--35.95%. The concentration of hemoglobin was 27.82 g/dl, 28.55 g/dl, 27.27 g/dl in the respective trimesters of pregnancy. In the umbilical blood it was 25.84 g/dl (5.2% less than in the maternal blood). The number of erythrocytes was the highest in the first (4.16 mln/mm3), and the lowest in the second trimester (3.92 mln/mm3). The average concentration of iron was the highest in the first trimester--99.61 microg/dl. In the second and third trimester it decreased by 25% and 2% respectively. The concentration was 76.34% higher in the umbilical blood than in maternal blood at the time of labor. The concentration of ferritin in the first trimester was 43.96 microg/l, in the second and the third trimester it was lower by 46% and 29% respectively. It was 126.4 microg/l in the umbilical blood (fourfold higher than in maternal blood). The concentration of transferrin was 321.01 mg/dl in the first trimester and it increased in consecutive trimesters by 36.14% and 5.12%; it was 219.92 mg/dl in the umbilical blood--48% of the concentration of transferrin in the maternal blood at the time of labor. The analysis of an average daily food ration revealed that the supply of iron was 80% of the recommended dose in the first half and only 41% of the recommended dose in the second half of the pregnancy. Fat consumption was 99% and 95% of the recommended dose, respectively. There was a 30%-decrease in the protein and carbohydrates consumption in comparison with the recommended dose in the second half of the pregnancy. CONCLUSIONS: In spite of normal hematological parameters, we observed insufficient supply of iron in the diet of pregnant women, which was demonstrated by a decreased level of ferritin. It should be reason enough to issue dietary recommendations and guidelines for pregnant women in each stage of pregnancy.
研究目的：本研究旨在评估正常健康孕期的铁状态标志物以及母亲饮食对其新生儿铁浓度的影响。 材料与方法：在母婴研究所进行产前护理的69名健康非吸烟孕妇样本中开展了一项纵向前瞻性研究。在孕早期、孕中期和孕晚期以及脐静脉采集血样。使用比浊法评估铁蛋白和转铁蛋白的浓度，采用亚铁嗪比色法测定铁的浓度。使用Pentra 120分析仪确定血液学参数。通过每周问卷评估母亲饮食，并使用计算机软件Dietetyk 2进行处理。 结果：分析的血液中的血液学参数正常。孕早期平均血细胞比容值为36.7%，孕中期为34.92%，孕晚期为35.95%。孕期各阶段血红蛋白浓度分别为27.82 g/dl、28.55 g/dl、27.27 g/dl。脐血中血红蛋白浓度为25.84 g/dl（比母血低5.2%）。红细胞数量在孕早期最高（416万/mm³），在孕中期最低（392万/mm³）。铁的平均浓度在孕早期最高——99.61μg/dl。在孕中期和孕晚期分别下降了25%和2%。分娩时脐血中铁浓度比母血高76.34%。孕早期铁蛋白浓度为43.96μg/l，孕中期和孕晚期分别降低了46%和29%。脐血中铁蛋白浓度为126.4μg/l（比母血高四倍）。孕早期转铁蛋白浓度为321.01mg/dl，在随后的孕期中依次增加了36.14%和5.12%；脐血中转铁蛋白浓度为219.92mg/dl——分娩时母血中转铁蛋白浓度的48%。对平均每日食物摄入量的分析表明，孕期前半段铁的摄入量为推荐剂量的80%，后半段仅为推荐剂量的41%。脂肪摄入量分别为推荐剂量的99%和95%。与推荐剂量相比，孕期后半段蛋白质和碳水化合物的摄入量减少了30%。 结论：尽管血液学参数正常，但我们观察到孕妇饮食中铁供应不足，这通过铁蛋白水平降低得到证明。这足以成为为孕期各阶段的孕妇发布饮食建议和指南的理由。
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