TITLE:
Routine Iron Supplementation during Pregnancy: Its Reflection on Iron and Oxidative Status in a Cohort of Pregnant Women in Kinshasa, DR Congo
AUTHORS:
Andy Muela Mbangama, Barthélémy Tandu-Umba, Roger Mwimba Mbungu
KEYWORDS:
Iron Supplementation, Pregnancy, Iron And Oxidative Status, Kinshasa
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.1,
January
25,
2019
ABSTRACT: Background:Due to maternal and fetal physiologic demand, the
rate along with amplitude of anemia is expected to rise over pregnancy. The iron and oxidative status also are
expected to vary accordingly. It is thus assumed that iron supplementation will
somewhat modify the profile observed in markers of iron and oxidative status of
our series. Objectives: We aimed to measure variations of indices of iron
and oxidative status of iron supplemented women over pregnancy. Methods: This is a prospective observational cohort of 74
pregnant women with singleton pregnancy whose baseline iron and oxidative status have been recently assessed at University
Clinics of Kinshasa, DR Congo. Women with anemia (Hb used t-test, chi-square test, ANOVAR and
regression, the significance being stated at p Results: Trimester wise evolution of hematologic status in
anemic women shows a rise in values of hemoglobin (+average 1 gr/dl) and
hematocrit (+3%) throughout pregnancy, with significant change only between
recruitment and 28 - 32 weeks. In non anemic women a significant decrease was
observed, although levels remained normal. For ferritin (7.5 - 53 ng/mL from
recruitment to term) and transferrin (107 - 157 g/L), significant rise was
found in anemic women from recruitment to 28 - 32 weeks, while in non anemic
notable change occurred only for transferrin (133 - 204 g/L). Serum iron
significantly increased (53 - 83 μg/dL) from recruitment to 28 - 32 weeks in
anemic women only. So, following supplementation, values of blood parameters
tended to be similar for both goups at term. Non anemic women did not benefit
from supplementation. SOD decreased and LDL values increased alongside supplementation. This
represents a growing oxidant threat for both anemic and non anemic women. This
could be related to iron overload and/or unabsorbed iron. Conclusion: Iron supplementation improved iron status in anemic
women, not in non anemic. Differences that were significant between groups at
recruitment disappeared by 28 - 32 weeks. Non anemic women did not benefit from
supplementation. SOD decreased and LDL values increased alongside
supplementation. This represents a growing oxidant threat for both anemic and
non anemic women. This could be related to
iron overload and/or unabsorbed iron. Doses of iron should be decreased (at least halved) and duration of treatment restricted to not more than 12 weeks.