IISPV, Unitat de Salut Pública i Nutrició, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.
Ann Hematol. 2013 Jan;92(2):221-9. doi: 10.1007/s00277-012-1578-z. Epub 2012 Oct 4.
Currently, there is no consensus regarding the optimum iron supplementation during pregnancy. The aim of this study is to evaluate the effect of different iron supplementation doses (including no supplementation) during pregnancy on the iron status of the mother and on the health of the neonate. A longitudinal study was conducted involving 358 pregnant women and their newborns. Mothers were classified as non-supplemented, low iron supplemented (<60 mg/day), moderate iron supplemented (between 60 and 100 mg/day) or high iron supplemented (>100 mg/day). General clinical and obstetric histories, haemoglobin (Hb), serum ferritin (SF) and transferrin saturation were evaluated in the first, second, third trimesters, and at partum. SF and Hb decreased less sharply in the iron-supplemented groups compared to the non-supplemented group. The higher the doses of iron supplementation, the lower the percentages of iron depletion at partum (p < 0.001), iron deficiency anaemia (p < 0.001) and preterm deliveries (p = 0.009) as well as a higher birth weight of the newborn. However, the group with high supplementation had a greater percentage (27.6 %) of women at risk of haemoconcentration at partum. Our Mediterranean women began gestation with iron stores close to deficit (SF, 28.1 μg/L; 95 % CI 27.9-28.4). With these iron stores, supplementation with iron at daily doses of between 60 and 100 mg appears to be the most beneficial for the health of mother and child. These findings need to be confirmed in further randomised clinical trials.
目前，对于妊娠期间最佳的铁补充剂量还没有共识。本研究旨在评估妊娠期间不同铁补充剂量（包括不补充）对母亲铁状态和新生儿健康的影响。进行了一项纵向研究，涉及 358 名孕妇及其新生儿。母亲分为未补充组、低铁补充组（<60mg/天）、中铁补充组（60-100mg/天）和高铁补充组（>100mg/天）。在孕早期、孕中期、孕晚期和分娩时评估了一般临床和产科病史、血红蛋白（Hb）、血清铁蛋白（SF）和转铁蛋白饱和度。与未补充组相比，铁补充组的 SF 和 Hb 下降幅度较小。铁补充剂量越高，分娩时铁耗竭（p<0.001）、缺铁性贫血（p<0.001）和早产（p=0.009）的比例以及新生儿出生体重越高。然而，高补充组有更多的产妇（27.6%）在分娩时存在血液浓缩的风险。我们的地中海女性在妊娠开始时铁储备接近不足（SF，28.1μg/L；95%CI 27.9-28.4）。在这些铁储备的基础上，每天补充 60-100mg 的铁似乎对母婴健康最有益。这些发现需要在进一步的随机临床试验中得到证实。
