TITLE:
Rationale of a Cohort Study on Risk of Obstetrical Outcomes Associated with Iron Supplementation during Pregnancy
AUTHORS:
Andy Muela Mbangama, Barthélémy Tandu-Umba, Roger Mwimba Mbungu
KEYWORDS:
Obstetrical Outcomes, Iron Supplementation, Oxidative Stress
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.6,
June
13,
2018
ABSTRACT: Background: Anemia is one of the most widely prevalent disorders, affecting the lives
of almost half a billion women of reproductive age, contributing to over 100,000
maternal and almost 600,000 perinatal deaths (mostly through pre-term delivery,
low birth weight) each year. Increased risk of infant mortality and reduced
cognitive development and reduced energy levels which affect productivity in
adults are cited. During pregnancy increased requirements, inadequate intake of
iron and other micronutrients and parasitic (malaria, hookworm) as wells
as bacterial (mostly urinary tract) infections are the main causes. In order to reduce such maternal and neonatal burden, it has been worldwide admitted to adopt
cost-effective preventive interventions during pregnancy, including iron-folic
acid supplementation, de-hookworming medication and anti-malarial prevention or treatment. Intestinal
absorption of iron is limited by a lot of factors including bioavailability,
iron status of the woman, substances accompanying or contained in diet,
chelating agents such as diet fibers or calcium salts. Any supplementation put
additional constraint in terms of absorption. Unabsorbed iron is known to have
pro-oxidant properties likely to induce production of free radicals. These in
turn might induce oxidative stress accountable for in generation of many
obstetrical outcomes. This potential link between oxidative stress resulting
from free radicals hyperproduction induced by non absorbed iron and harmful
maternal/perinatal conditions is rarely questioned by searchers. Objectives: To determine overall (food and supplemented) iron consumption, iron and
oxidative status in a cohort of pregnant women and to seek associations between
findings and adverse obstetrical outcomes. Methods: At the University
Clinics of Kinshasa, we designed a protocol for a prospective cohort study
dealing with clinical and biochemical parameters of oxidative stress among
pregnant women iron supplemented. Women with a single pregnancy not exceeding
19 weeks without obvious pathology, regardless of age and parity, were eligible
for inclusion in the study. Conclusion: This study is expected to assess
consequences of oral iron supplementation during pregnancy in terms of
obstetrical outcomes associated with oxidative stress linked to unabsorbed
iron.