Browse > Article

Is Selective Iron Supplementation Needed During Gestation?  

Park, Cheol-Hoon (Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea)
Kweon, In (Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea)
Lee, Jong-Kun (Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea)
Seo, Keong-A (Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea)
Lim, Heon-Woo (Department of Preventive Medicine, College of Medicine, The Catholic University of Korea)
Kim, Yong-Wook (Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea)
Lee, Young (Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea)
Rha, Jong-Gu (Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea)
Publication Information
Obstetrics & gynecology science / v.47, no.1, 2004 , pp. 45-50 More about this Journal
Abstract
Objective : It is controversial whether routine or selective iron supplementation during gestation is needed. The aim of this study is to evaluate whether screening with serum ferritin during the first trimester of pregnancy could be identify women who need prophylactic iron supplementation. Methods : According to the serum ferritin level of cut-off point of 30 $\mu$g/L during the first trimester of pregnancy and the presence of iron supplementation during gestation, the subject was divided into 4 group that were as follows: serum ferritin level of $\leq$30 $\mu$g/L and iron-supplemented group (n=22), serum ferritin level of $\leq$30 $\mu$g/L and non iron-supplemented group (n=13), serum ferritin level of >30 $\mu$g/L and ironsupplemented group (n=40), serum ferritin level of >30 $\mu$g/L and non iron-supplemented group (n=15). Maternal serum ferritin, TIBC, iron, hemoglobin, hematocrit, red cell indices (MCV, MCH, MCHC, RDW) were measured before 14 weeks of gestation and after 34 weeks of gestation. Results : All hematologic and biochemical markers indicated more severe anemic status in the late pregnancy than during the first trimester of pregnancy. The effect of iron supplementation was profounder on the pregnant woman whose ferritin levels were below 30 $\mu$g/L during the first trimester of pregnancy. Regardless of iron supplementation, the group (ferritin >30 $\mu$g/L during the first trimester of pregnancy) showed relatively higher ferritin level in late pregnancy. Conclusion : The screening with serum ferritin level of cut-off point of 30 $\mu$g/L during the first trimester of pregnancy may be useful to identify women who need prophylactic iron supplementation.
Keywords
Iron; Ferritin; Selective iron supplementation;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 World Health Organization. The Prevalence of Anaemia in Women. WHO/MCH/MSM/92.2 1992
2 DeMayer E, Adiels-Tegman M. The prevalence of anemia in the world. World Health Statistics Quarterly 1985; 38: 302-16
3 MacPhail, P. & Bothwell, TH. The prevalence and causes of nutritional iron deficiency anemia. Nutritional anemias(ed. by S.J. Fomon and S. Zlotkin). Nestle Nutrition Workshop Series 1992; 32: 1-9
4 Hallberg L. Prevention of iron deficiency. Baillieres Clinical Haematology 1994; 7: 805-14   DOI   PUBMED   ScienceOn
5 Letsky EA. The hematological system. In: F. Hytten and G. Chamberlain, editors. Clinical Physiology in Obstetrics. 3rd ed. Oxford: Blackwell Science; 1998
6 Report of a Joint FAO/WHO Expert Consultation. Requirements of vitamin A, iron, folate and vitamin B12. FAO food and Nutritional Series 1988; 23: 33-50
7 Centers for Disease Control and Prevention. Recommendations to prevent and control iron deficiency in Unitied States. MMWR 1989; 38: 400-4
8 Elina H, Jouni M. Long-term follow-up mothers and their infants in a randomized trial on iron prophylaxis during pregnancy. Am J Obstet Gynecol 1995; 173: 205-9   DOI   ScienceOn
9 Steffensen R, Varming K, jersild C. Determination of gene frequencies for two chain common hemochromatosis mutations in the Danish population by a novel polymerase reaction with sequence-specific primers. Tissue Antigens 1998; 52: 230-5   DOI   ScienceOn
10 Milman N, Gradual N, Galloe A, Agger AO. Serum ferritin and selective iron prophylaxis in pregnancy? J Intern Med 1996; 240: 47-50
11 Romslo I, haram K, Sagen N, Augensen K. Iron requirements in normal pregnancy as assessed by serum ferritin, serum transferrin saturation and erythrocyte protoporphyrin determinations. Br J Obstet Gynecol 1993; 90: 101-7
12 Tietz NW, Rinker AD, Morrison SR. When is a serum iron really a serum iron? The status of seum iron measurements. Clinical Chemistry. 1994; 40: 546-51
13 Goldenberg RL, Tamura T, Dubard M, Johnston KE, Copper RL, Neggers Y, et al. Plasma ferrtin and pregnancy outcome. Am J Obstet Gynecol 1996; 175: 1356-9   DOI   ScienceOn
14 Prichard JA, Scott DE. Iron demands during pregnancy. In: Iron Deficiency-pathogenensis: Clinical Aspects and Therapy. London: Acaemic Press; 1970. P.13
15 Milman N, Gradual NA, Agger AO. Iron status markers during pregnancy. No relationship between levels in the beginning of the second trimester. prior delivery and postpartum. J Intern Med 1995; 237: 261-7
16 Cook, J.D. Iron deficiency anaemia. Baillieres Clinical Haematology 1994; 7: 787-804   DOI   PUBMED   ScienceOn
17 Van den Broek NR, Letsky EA, White SA, Shenkin A. Iron status in pregnant women: Which measurements are valid? Br J Haematol 1998; 103: 817-24   DOI   ScienceOn