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重新探讨丹麦孕妇的铁补充:对产前和产后缺铁、贫血、血清促红细胞生成素的影响;包括新生儿的铁状态、促红细胞生成素和人体测量学。一项随机、安慰剂对照研究。

Iron supplementation in pregnant Danish women revisited: Effects on prepartum and postpartum iron deficiency, anemia, serum erythropoietin; including iron status, erythropoietin and anthropometrics in newborns. A randomized, placebo-controlled study.

机构信息

Department of Clinical Biochemistry, Naestved Hospital, Zealand University College, Naestved, Denmark.

出版信息

J Neonatal Perinatal Med. 2022;15(4):731-744. doi: 10.3233/NPM-221014.

DOI:10.3233/NPM-221014
PMID:35811545
Abstract

OBJECTIVE

To assess effects of iron supplementation, 66 mg elemental iron daily as ferrous fumarate, on iron status markers during normal pregnancies.

METHODS

Randomized, double-blind, placebo-controlled study of 119 women (62 iron-, 57 placebo -treated) and their newborns. Hemoglobin (Hb), serum (S)-ferritin, S-transferrin saturation percentage (TSAT) and S-erythropoietin (S-EPO) were measured at 14-18, 24-27 weeks of gestation, prepartum, 1 and 8 weeks postpartum.

RESULT

From 24-27 weeks gestation to 8 weeks postpartum, the iron group had higher Hb, S-ferritin and TSAT than the placebo group; prepartum, 11% had iron deficiency (ID) and 0% iron deficiency anemia (IDA) in the iron group, vs 60% and 18% in the placebo group; 8 weeks postpartum 1.6% in the iron group had ID and 1.6% IDA vs 14% and 7% in the placebo group. S-EPO levels in the iron group were lower than in the placebo group (p < 0.001). Mothers prepartum S-EPO values were correlated to newborns cord S-EPO values (p < 0.001). Newborns to iron treated mothers had higher cord S-ferritin levels than those to placebo treated mothers (p = 0.02). Newborn girls had higher cord S-ferritin levels than boys (p < 0.01). There was no impact of iron supplementation on the length of gestation, placental weight, or newborns birth weight. Birth weight was correlated only with mothers' body weight, length of gestation and placental weight.

CONCLUSION

Iron supplementation had a "positive" impact on iron status and Hb both during pregnancy and postpartum, with a low frequency of ID/IDA and also a "positive" influence on newborns iron status.

摘要

目的

评估每日补充 66 毫克元素铁(富马酸亚铁)对正常妊娠期间铁状态标志物的影响。

方法

对 119 名女性(62 名补铁,57 名安慰剂治疗)及其新生儿进行了随机、双盲、安慰剂对照研究。在 14-18 周、24-27 周妊娠、产前、产后 1 周和 8 周时测量血红蛋白(Hb)、血清(S)-铁蛋白、S-转铁蛋白饱和度(TSAT)和 S-促红细胞生成素(S-EPO)。

结果

从 24-27 周妊娠到产后 8 周,补铁组的 Hb、S-铁蛋白和 TSAT 均高于安慰剂组;产前,补铁组 11%有缺铁(ID),0%有缺铁性贫血(IDA),而安慰剂组分别为 60%和 18%;产后 8 周,补铁组 1.6%有 ID,1.6%有 IDA,而安慰剂组分别为 14%和 7%。补铁组的 S-EPO 水平低于安慰剂组(p<0.001)。补铁组母亲产前 S-EPO 值与新生儿脐带 S-EPO 值相关(p<0.001)。接受补铁母亲的新生儿脐带 S-铁蛋白水平高于接受安慰剂母亲的新生儿(p=0.02)。女婴的脐带 S-铁蛋白水平高于男婴(p<0.01)。补铁对妊娠和产后的胎龄、胎盘重量或新生儿出生体重均无影响。出生体重仅与母亲的体重、胎龄和胎盘重量相关。

结论

铁补充剂对妊娠和产后的铁状态和 Hb 均有“积极”影响,ID/IDA 的发生率较低,对新生儿的铁状态也有“积极”影响。

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