Shankar Hari, Kumar Neeta, Sandhir Rajat, Pandey Sanjay, Singh Saurabh, Verma Priyanka, Singh M P, Adhikari Tulsi, Mittal Suneeta, Rao D N
1Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029 India.
3Department of Biochemistry, Panjab University, Chandigarh, 160018 India.
Indian J Clin Biochem. 2020 Jan;35(1):43-53. doi: 10.1007/s12291-018-0794-2. Epub 2018 Oct 5.
The molecular mechanism of iron transfer across placenta in response to maternal anemic status/ iron supplementation is not clear. We hypothesized that maternal iron/ anemia status during early trimesters can be utilized as a biomarker tool to get estimates of placental iron status. Early interventions can be envisaged to maintain optimum placental/ foetal iron levels for healthy pregnancy outcomes. One hundred twenty primigravida were recruited and divided into non-anemic and anemic group on the basis of hemoglobin levels. The groups were randomly allocated to receive daily and weekly iron folic acid (IFA) tablets till six weeks postpartum. Hematological and iron status markers in blood and placenta were studied along with the delivery notes. Weekly IFA supplementation in anemic primigravidas resulted in significantly reduced levels of hematological markers ( < 0.01); whereas non-anemic primigravidas showed lower ferritin and iron levels, and higher soluble transferrin receptor levels ( < 0.05). At baseline, C-reactive protein and cortisol hormone levels were also significantly lower in non-anemic primigravidas ( < 0.05). A significantly decreased placental ferritin expression ( < 0.05); and an increased placental transferrin expression was seen in anemic primigravidas supplemented with weekly IFA tablets. A significant positive correlation was observed between serum and placental ferritin expression in anemic pregnant women (r = 0.80; < 0.007). Infant weight, gestational length and placental weight were comparable in both the supplementation groups. To conclude, mother's serum iron / anemia status switches the modulation in placental iron transporter expression for delivering the optimum iron to the foetus for healthy pregnancy outcomes.
Clinical Trial Registry-India: CTRI/2014/10/005135.
铁在胎盘转运以响应母体贫血状态/铁补充的分子机制尚不清楚。我们假设孕早期母体的铁/贫血状态可作为一种生物标志物工具来评估胎盘铁状态。可以设想进行早期干预，以维持最佳的胎盘/胎儿铁水平，实现健康的妊娠结局。招募了120名初产妇，根据血红蛋白水平分为非贫血组和贫血组。这些组被随机分配接受每日和每周的铁叶酸（IFA）片，直至产后六周。研究了血液和胎盘中的血液学和铁状态标志物以及分娩记录。贫血初产妇每周补充IFA可使血液学标志物水平显著降低（<0.01）；而非贫血初产妇的铁蛋白和铁水平较低，可溶性转铁蛋白受体水平较高（<0.05）。在基线时，非贫血初产妇的C反应蛋白和皮质醇激素水平也显著较低（<0.05）。在每周补充IFA片的贫血初产妇中，胎盘铁蛋白表达显著降低（<0.05）；胎盘转铁蛋白表达增加。贫血孕妇血清和胎盘铁蛋白表达之间存在显著正相关（r = 0.80；<0.007）。两个补充组的婴儿体重、妊娠长度和胎盘重量相当。总之，母亲的血清铁/贫血状态会改变胎盘铁转运蛋白的表达调节，以便为胎儿输送最佳的铁，实现健康的妊娠结局。
印度临床试验注册中心：CTRI/2014/10/005135。
