The Role of Iron Adequacy for Maternal and Fetal Health

  • Ali Sungkar Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Keywords: Nutrition, maternal, fetal, development

Abstract

Nearly half of pregnant women in the world are reported to suffer anemia. And most of them are caused by iron deficiency, while the others by folate, vitamin B12 or vitamin A deficiency, chronic inflammation, parasite infections and hereditary disorders. Anemia in pregnant women is characterized when < 11 g / dL or any time during pregnancy. And when followed by low iron, it's called iron deficiency anemia. Iron plays an important role in many metabolic processes by transporting oxygen and allowing cells to generate energy. Low iron levels during pregnancy leading to anemia, related to an heightened risk of mother and fetus disease. Iron deficiency anemia can affect fetal development and persist long-term, while mild and serious pregnancy anemia can lead to premature birth, maternal and child mortality, bleeding, and infectious disease. The iron requirement during pregnancy exceeds 1000 mg for red cell expansion, 300 mg – 350 mg for developing fetus and placenta, and 250 mg for variable blood loss at delivery. Iron adequacy during pregnancy can be assured by proper nutrition, iron supplementation and fortification, and intravenous iron or blood transfusion. Iron supplementation is only enough to cover the prenatal iron requirements. Summary: Iron deficiency leading to anemia, rising risk of negative pregnancy outcomes. To meet increasing iron requirements during pregnancy including iron supplementation, fortification of staple iron foods, and intravenous iron or blood transfusion if required.

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Author Biography

Ali Sungkar, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Maternal-Fetal Division, Department of Obstetry and Gynecology

References

Abbaspour N, Hurrell R, Kelishadi R.Review on iron and its importance for human health. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 2014. 19(2):164.

Gupta C.Role of iron (Fe) in body. IOSR Journal of Applied Chemistry 2014. 7(11):38-46.

Oliveira F, Rocha S, Fernandes R.Iron metabolism: from health to disease. Journal of clinical laboratory analysis 2014. 28(3):210-8.

Gkouvatsos K, Papanikolaou G, Pantopoulos K.Regulation of iron transport and the role of transferrin. Biochimica et Biophysica Acta (BBA)-General Subjects 2012. 1820(3):188-202.

Grzeszczak K, Kwiatkowski S, Kosik-Bogacka D.The Role of Fe, Zn, and Cu in Pregnancy. Biomolecules 2020. 10(8):1176.

Han O.Molecular mechanism of intestinal iron absorption. Metallomics 2011. 3(2):103-9.

Friedrisch JR, Friedrisch BK.Prophylactic iron supplementation in pregnancy: a controversial issue. Biochemistry insights 2017. 10:1178626417737738.

Georgieff MK, Krebs NF, Cusick SE.The benefits and risks of iron supplementation in pregnancy and childhood. Annual review of nutrition 2019. 39:121-46.

Brannon PM, Taylor CL.Iron supplementation during pregnancy and infancy: Uncertainties and implications for research and policy. Nutrients 2017. 9(12):1327.

Cappellini MD, Musallam KM, Taher AT.Iron deficiency anaemia revisited. Journal of internal medicine 2020. 287(2):153-70.

McArdle HJ, Gambling L, Kennedy C.Iron deficiency during pregnancy: the consequences for placental function and fetal outcome. Proceedings of the Nutrition Society 2014. 73(1):9-15.

Juul SE, Derman RJ, Auerbach M.Perinatal iron deficiency: implications for mothers and infants. Neonatology 2019. 115(3):269-74.

Scholl TO.Maternal iron status: relation to fetal growth, length of gestation, and iron endowment of the neonate. Nutrition reviews 2011. 69(suppl_1):S23-S9.

Alwan NA, Hamamy H.Prenatal Exposures and Short and Long Term Developmental Outcomes: Maternal Iron Status in Pregnancy and Long-Term Health Outcomes in the Offspring. Journal of pediatric genetics 2015. 4(2):111.

Fisher AL, Nemeth E.Iron homeostasis during pregnancy. The American journal of clinical nutrition 2017. 106(suppl_6):1567S-74S.

Demuth IR, Martin A, Weissenborn A.Iron supplementation during pregnancy–a cross-sectional study undertaken in four German states. BMC pregnancy and childbirth 2018. 18(1):491.

Di Renzo GC, Spano F, Giardina I, Brillo E, Clerici G, Roura LC.Iron deficiency anemia in pregnancy. Women’s Health 2015. 11(6):891-900.

Frass KA.Postpartum hemorrhage is related to the hemoglobin levels at labor: Observational study. Alexandria Journal of Medicine 2015. 51(4):333-7.

Osungbade KO, Oladunjoye AO.Preventive treatments of iron deficiency anaemia in pregnancy: a review of their effectiveness and implications for health system strengthening. Journal of pregnancy 2012. 2012.

Stephen G, Mgongo M, Hussein Hashim T, Katanga J, Stray-Pedersen B, Msuya SE.Anaemia in pregnancy: Prevalence, risk factors, and adverse perinatal outcomes in Northern Tanzania. Anemia 2018. 2018.

Yi S, Han Y, Ohrr H.Anemia before pregnancy and risk of preterm birth, low birth weight and small-for-gestational-age birth in Korean women. European journal of clinical nutrition 2013. 67(4):337-42.

Milman N.Postpartum anemia II: prevention and treatment. Annals of hematology 2012. 91(2):143-54.

Preziosi P, Prual A, Galan P, Daouda H, Boureima H, Hercberg S.Effect of iron supplementation on the iron status of pregnant women: consequences for newborns. The American journal of clinical nutrition 1997. 66(5):1178-82.

Rodriguez-Bernal C, Rebagliato M, Ballester F.Maternal nutrition and fetal growth: the role of iron status and intake during pregnancy. Nutrition and Dietary Supplements 2012. 4:25.

Radlowski EC, Johnson RW.Perinatal iron deficiency and neurocognitive development. Frontiers in human neuroscience 2013. 7:585.

Pala E, Erguven M, Guven S, Erdogan M, Balta T.Psychomotor development in children with iron deficiency and iron-deficiency anemia. Food and nutrition bulletin 2010. 31(3):431-5.

Sumarlan ES, Windiastuti E, Gunardi H.Iron status, prevalence and risk factors of iron deficiency anemia among 12-to 15-year-old adolescent girls from different socioeconomic status in Indonesia. Makara Journal of Health Research 2018. 22(1):8.

Taner CE, Ekin A, Solmaz U, Gezer C, Çetin B, Keleşoğlu M, et al.Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery. Journal of the Turkish German Gynecological Association 2015. 16(4):231.

Uijterschout L, Vloemans J, Rövekamp-Abels L, Feitsma H, van Goudoever JB, Brus F.The influences of factors associated with decreased iron supply to the fetus during pregnancy on iron status in healthy children aged 0.5 to 3 years. Journal of Perinatology 2014. 34(3):229-33.

Burke RM, Leon JS, Suchdev PS.Identification, prevention and treatment of iron deficiency during the first 1000 days. Nutrients 2014. 6(10):4093-114.

Pavord S, Myers B, Robinson S, Allard S, Strong J, Oppenheimer C, et al.UK guidelines on the management of iron deficiency in pregnancy. British journal of haematology 2012. 156(5):588-600.

Cantor AG, Bougatsos C, Dana T, Blazina I, McDonagh M.Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the US Preventive Services Task Force. Annals of internal medicine 2015. 162(8):566-76.

Iqbal S, Ekmekcioglu C.Maternal and neonatal outcomes related to iron supplementation or iron status: a summary of meta-analyses. The Journal of Maternal-Fetal & Neonatal Medicine 2019. 32(9):1528-40.

Long H, Yi J-M, Hu P-L, Li Z-B, Qiu W-Y, Wang F, et al.Benefits of iron supplementation for low birth weight infants: a systematic review. BMC pediatrics 2012. 12(1):99.

Short MW, Domagalski JE.Iron deficiency anemia: evaluation and management. American family physician 2013. 87(2):98-104.

Jimenez K, Kulnigg-Dabsch S, Gasche C.Management of iron deficiency anemia. Gastroenterology & Hepatology 2015. 11(4):241.

Kim D, Mendez-Figueroa H, Anderson BL.Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions. Case reports in obstetrics and gynecology 2013. 2013.

Submitted

2021-05-18
Accepted
2021-06-16
Published
2021-06-29