Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, P.O. Box-271, Colombo 8, Sri Lanka.
Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Eur J Nutr. 2021 Mar;60(2):1101-1109. doi: 10.1007/s00394-020-02320-2. Epub 2020 Jul 1.
We evaluated the effectiveness of iron supplementation in relation to baseline iron and inflammatory status of pregnant women and their offspring in Sri Lanka.
Apparently healthy women aged 18-36 years at < 12 weeks of gestation prior to receiving any supplementation were randomly recruited at the antenatal clinics. They received 60 mg of elemental iron in combined iron-folic acid pills from 12 weeks of gestation until delivery via the National Maternal Supplementation Programme. Serum ferritins (SF), hemoglobin and high-sensitive C-reactive protein (hs-CRP) were assessed. The women were grouped as iron sufficient-inflammation (+), iron sufficient-inflammation (-), iron deficient-inflammation (+) and iron deficient-inflammation (-) based on their baseline iron stores and low-grade inflammation (hs-CRP > 5 < 10 mg/L) at baseline and late pregnancy.
Despite supplementation, SF in the iron sufficient-inflammation (+) women reduced significantly (p = 0.037) to deficiency state (SF < 30 µg/L) at mid-pregnancy. Whereas no significant changes were noted in the SF in iron sufficient-inflammation (-) women (p > 0.05). They maintained their stores at sufficient state until delivery. The cord SF was higher (p < 0.001) in iron sufficient-inflammation (-) than the inflammation (+) women. 96.4% of the iron deficient women remained deficient until delivery regardless of their inflammatory state. Low-grade inflammation was higher (p < 0.001) in women with baseline BMI > 25 kg/m. Whereas inflammation at late pregnancy was higher (p < 0.001) in women who gained weight in excess of the recommended, regardless of their baseline BMI.
Iron status prior to supplementation and low-grade inflammation associated with BMI > 25 kg/m and excess weight gain during pregnancy appear to modulate the effectiveness of iron supplementation.
我们评估了铁补充剂对斯里兰卡孕妇及其后代基线铁和炎症状态的影响。
在接受任何补充剂之前，年龄在 18-36 岁之间的健康孕妇在妊娠 12 周前被随机招募到产前诊所。她们从妊娠 12 周开始接受国家孕产妇补充计划提供的含有 60 毫克元素铁的复合铁叶酸片。评估血清铁蛋白（SF）、血红蛋白和高敏 C 反应蛋白（hs-CRP）。根据孕妇的基线铁储备和低水平炎症（hs-CRP>5<10mg/L），将其分为铁充足-炎症（+）、铁充足-炎症（-）、铁缺乏-炎症（+）和铁缺乏-炎症（-）。
尽管补充了铁，但铁充足-炎症（+）组的 SF 在妊娠中期显著降低（p=0.037）至缺乏状态（SF<30μg/L）。而铁充足-炎症（-）组的 SF 没有显著变化（p>0.05）。直到分娩时，她们的铁储备仍处于充足状态。铁充足-炎症（-）组的脐带 SF 明显高于炎症（+）组（p<0.001）。96.4%的铁缺乏女性无论炎症状态如何，分娩时仍处于缺乏状态。低水平炎症在基线 BMI>25kg/m 的女性中更高（p<0.001）。而在妊娠晚期，无论基线 BMI 如何，体重增加超过推荐量的女性炎症水平更高（p<0.001）。
补充前的铁状态和与 BMI>25kg/m 和妊娠期间体重过度增加相关的低度炎症似乎会影响铁补充的效果。
