IISPV, Unidad de Nutrición y Salud Pública, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201 Reus, Spain.
Hum Reprod. 2012 May;27(5):1260-6. doi: 10.1093/humrep/des026. Epub 2012 Feb 21.
Gestational iron-deficiency anaemia has adverse pregnancy outcomes. Antenatal iron supplementation can be beneficial in anaemic women, but the effects in non-anaemic women are controversial. This observational study assessed the relationship of maternal iron stores (depleted or non-depleted) at gestational Weeks 8-12 with birthweight, in non-anaemic pregnant women following the guidelines of the Ministry of Health of Spain.
Healthy, non-anaemic pregnant women (n = 205) were studied. At the first antenatal visit, a general clinical assessment was conducted, and basal blood taken. Women were classified as having non-depleted or depleted iron stores [serum ferritin (SF) < 12 µg/l)]. Daily antenatal iron supplements (48 mg on average) were started at 17 (range: 16-18) weeks. Blood haemoglobin, SF and transferrin saturation (TS) were measured in each trimester.
Of the study sample, 20, 54 and 66% had SF < 12 µg/l in the first, second and third trimesters, respectively. The prevalence of iron-depletion (SF < 12 µg/l) and iron-deficiency (SF < 12 µg/l and TS < 16%) was greater during the entire pregnancy in women with initial iron depletion versus no depletion (81.6 and 73.7% versus 61.7 and 55.4%, respectively, in the third trimester, P < 0.05). Women with initial iron-depletion delivered babies weighing on average 192 g less than that with initial iron stores, after adjusting for confounding variables (P = 0.028).
Beginning pregnancy with non-depleted iron stores is beneficial for the maternal iron status during pregnancy and infant birthweight. These findings reaffirm the importance of health promotion to ensure that women have adequate iron stores prior to, or early in, pregnancy when supplemented with moderate daily iron doses.
妊娠期缺铁性贫血会对妊娠结局产生不良影响。产前铁补充对贫血妇女有益，但对非贫血妇女的效果存在争议。本观察性研究评估了西班牙卫生部指南指导下，妊娠 8-12 周时母体铁储备（耗竭或未耗竭）与非贫血孕妇的出生体重之间的关系。
研究了 205 例健康的非贫血孕妇。在第一次产前检查时，进行了一般临床评估，并采集了基础血液。根据血清铁蛋白（SF）<12μg/l，将女性分为铁储备未耗竭或耗竭[铁储备未耗竭（SF）<12μg/l]。平均每天补充 48mg 产前铁剂（范围：16-18 周）。每三个月测量一次血红蛋白、SF 和转铁蛋白饱和度（TS）。
在研究样本中，分别有 20%、54%和 66%的孕妇在第一、二和三季度 SF<12μg/l。与无铁耗竭组相比，初始铁耗竭组的铁耗竭（SF<12μg/l）和缺铁（SF<12μg/l 且 TS<16%）的患病率在整个孕期更高（分别为第三季度的 81.6%和 73.7%，以及 55.4%和 55.4%，P<0.05）。调整混杂变量后，初始铁耗竭组的孕妇所生婴儿平均体重比初始铁储备组少 192g（P=0.028）。
在妊娠开始时铁储备未耗竭，有利于孕妇妊娠期间的铁状态和婴儿出生体重。这些发现再次证实了健康促进的重要性，以确保女性在怀孕前或怀孕早期有足够的铁储备，同时补充适量的每日铁剂。
