Departments of Internal Medicine, Medical Education, and Pathology, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614, USA.
Internal Medicine, Building 2/Room 109, Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614, USA.
Nutrients. 2020 Feb 11;12(2):447. doi: 10.3390/nu12020447.
A normal pregnancy consumes 500-800 mg of iron from the mother. Premenopausal women have a high incidence of marginal iron stores or iron deficiency (ID), with or without anemia, particularly in the less developed world. Although pregnancy is associated with a "physiologic" anemia largely related to maternal volume expansion; it is paradoxically associated with an increase in erythrocyte production and erythrocyte mass/kg. ID is a limiting factor for this erythrocyte mass expansion and can contribute to adverse pregnancy outcomes. This review summarizes erythrocyte and iron balance observed in pregnancy; its implications and impact on mother and child; and provides an overview of approaches to the recognition of ID in pregnancy and its management, including clinically relevant questions for further investigation.
正常妊娠期间母体从饮食中摄取 500-800mg 的铁。围绝经期女性铁储量不足或缺铁(ID)的发生率较高,无论是否伴有贫血,尤其是在欠发达地区。尽管妊娠相关“生理性”贫血在很大程度上与母体血容量扩张有关,但它与红细胞生成和红细胞质量/公斤增加呈正相关。ID 是红细胞质量扩张的限制因素,可能导致不良妊娠结局。本文综述了妊娠期间红细胞和铁平衡的变化;其对母婴的影响和意义;并概述了妊娠 ID 的识别和处理方法,包括对进一步研究有临床意义的问题。