• Korean Journal of Community Nutrition
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• v.3 no.4
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• pp.565-573
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• 1998

Iron deficiency anemia in pregnant women has been of great concern because of its negative effects on the outcomes of pregnancy. Much of evidence has shown that there are associations between pregnancy outcomes and maternal iron status. Maternal iron status might affect pregnancy outcomes through the iron status of the cord blood. In this study, we divided 91 subjects into two groups : the anemic and the normal groups. The groups were classified according to their hemoglobin(Hb) and hematocrit(Hct) values of the maternal blood in the third trimester of the pregnancies. We determined the parameters for the iron status of the cord blood and then analyzed the correlations between these parameters and the pregnancy outcomes. Mothers in the anemic group had a significantly higher parity number and a lower dietary score as well as a shorter duration of iron supplements consumed compared to those in the normal group. Maternal Hb values in the third trimester had positive correlations with the infant's head and chest circumferences, and the Hct values related positively to the infant's chest circumferences. On the other hand, Hb concentrations of the cord blood had positive correlations with the infant's height and head and chest circumferences. The Hct values of the cord blood had positive correlations with gestational periods and the cord lengths. These results suggest that the maternal iron status might influence fetal development through the iron status of the cord blood.

• Journal of Nutrition and Health
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• v.32 no.7
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• pp.793-801
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• 1999

The purposes of this study are to assess iron status in mothers and their newborn infants at birth and to analyze the influence of maternal iron status on their newborn babies. Venous bloods samples were drawn from 144 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth for measurement of hemoglobin, hematocrit, serum iron, ferritin, total binding capacity and transferrin saturation. The values of hemoglobin and hematocrit were significantly lower in the mothers(10.9$\pm$1.43g/dl and 33.7$\pm$3.67%) than in their newborn infants(14.7$\pm$1.43g/dl and 45.3$\pm$4.76%)(p<0.0001). At delivery, serum iron levels in cord blood were about twice as high as those in the maternal blood, and serum ferritin levels in the cord blood were about four times higher than those in the maternal blood. The serum ferritin levels of multigravidas were higher than those of primigravidas,. but there was no difference between the serum ferritin levels of their infants. The serum ferritin levels of the mothers and their infants were higher in maternal group with iron supplement regularly than in other maternal group without iron supplement during pregnancy. Among the mothers, 26.4% had a serum ferritin levels below 12ng/ml(i.e. depleted iron stores)and 78.9% had a hemoglobin below 12g/dl(i.e.iron deficient anemia). When the maternal group was classified according to their serum ferritin levels by 9ng/ml, 12ng/dl or 20ng/ml, there was no significant difference in the iron status of their newborn infants among the three groups. The hemoglobin and serum ferritin levels of the mothers were well correlated with those of their babies. The maternal hemoglobin values negatively correlated with infant birth weight. It is possible that the demands of iron of the mother might be increased in the case of a newborn infant of greater size. The results of this study provide useful information regarding establishment of RDA for iron in pregnant women and guidance about the need for iron supplement during pregnancy.

• Korean Journal of Community Nutrition
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• v.7 no.5
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• pp.686-695
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• 2002

The purpose of this study is to assess the maternal iron status during pregnancy and to evaluate the relationships bet-ween the iron indices of maternal, umbilical cord serum, placenta and pregnancy outcomes. Venous bloods samples were drawn from 54 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth. And also, placental tissues were extracted. We investigated the difference of the iron status indices of maternal, umbilical cord serum and placental tissue between two gestational age group (PT group, NT group : preform delivery and normal term delivery at 34.9wk and 39.0wk of mean gestational length, respectively) and also assessed correlations of iron status indices of maternal, umbilical cord serum and placenta tissue. And lastly, we related between birth weight and iron status indices of maternal, umbilical cord serum and placental tissue. The concentrations of maternal serum ferritin and of placental iron were significantly higher in NT group (32.1 $\pm$ 21.1 ng/ml, 68.5 $\pm$ 16.7 $\mu$g/g), than those of NT group (20.8 $\pm$ 11.6 ng/ml, 53.2 $\pm$ 17.4 $\mu$/g) respectively (p<0.001). However the serum ferritin of umbilical cord were significantly higher in NT group (PT : 109.4 $\pm$ 65.7 ng/ml, NT : 147.0 $\pm$ 56.8 ng/ml) than those of PT group (p<0.05). Our results showed that a negative association between birth weight (r=-0.361) and maternal serum ferritin and that a positive association between birth weight and umbilical cord serum ferritin (r=0.261). Despite not a significant difference, there was tendency that highest concentration of maternal serum ferritin was associated with the lowest birth weight. These findings indicate that birth weight of newborn is dependent of multiple factors such as maternal iron status during pre-pregnancy, body size, general nutritional status. Although for women who enter pregnancy with low iron stores, enough intakes of iron during pregnancy could produce undesirable pregnancy outcome. Therefore we suggest for successful pregnancy outcome and delivery differential iron supplementation program will be carried out individual pregnant women on the basis of pre-pregnancy nutritional status.

• Korean Journal of Community Nutrition
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• v.6 no.2
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• pp.182-191
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• 2001

Anemia in women during pregnancy and after delivery has been known to affect the mother, the fetus, and the infant's growth and health status. Studies examining, changes in iron and folate status associated with anemia during pregnancy and during pregnancy, and those supplements are stopped after postpartum. However, the effects of those have not been clearly determined in pregnant and lactating Korea women. Therefore, this study was performed to determine the changes in maternal iron and folate status during pregnancy and six months after delivery longitudinally in six pregnant women who consumed supplements from 20 wk to delivery. We concluded that the iron status deteriorated during pregnancy and especially was weak in the third trimester, but had a tendency to recovery after delivery. On the other hand, the folate status deteriorated in the first and second trimester and was good in the third trimester, but had a tendency to decrease after delivery. These results suggested that the iron status was not improved despite consuming total iron supplements of 50 mg/day through diets and supplements during the second half of the pregnancy. On the other hand, the folate status improved at the end of pregnancy by consuming folate supplements of a total of 800 mg/day through diets and supplements. However, folate status was poor in the first half of the pregnancy, and the tendency of folate status to decrease during postpartum was advanced. At the point in which iron and therefore supplementation is essential. However, the effects of supplement intake time and intake dosage need to be verified and the nutritional status changes of postpartum women should be carefully monitored.

• Korean Journal of Community Nutrition
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• v.10 no.6
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• pp.860-868
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• 2005

Anemia diagnosed early in pregnancy is associated with increased risks of low birth weight and preform delivery. The purposes of this study were to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal-umbilical cord serum iron and ferritin levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum iron and ferritin levels in maternal blood and umbilical cord were measured at 1st-, 2nd-, 3rd- trimester and delivery, respectively. The mean of maternal se겨m iron levels of the trimester and delivery were $124.27\;{\mu}g/dl,\;97.03\;{\mu}g/dl,\;94.32\;{\mu}g/dl,\;and\;145.53\;{\mu}g/dl$. Those maternal levels were significantly lower than that of umbilical cord blood ($222.59\;{\mu}g/dl$). Serum ferritin levels of maternal trimester and delivery were 22.68 $22.68\;{\mu}g/l,\;11.09\;{\mu}g/l,\;14.18\;{\mu}g/l,\;and\;\;24.54\;{\mu}g/l$, which were significantly lower than those of umbilical cord blood ($184.35\;{\mu}g/l$) (p < 0.0001). This prevalence of anemia of total subjects was $30.3\%$ by WHO criteria (Hb < 11.0 g/dl, Hct < $33\%$). Iron levels of 2nd-trimester was significantly higher in the normal group than in the anemia group. And ferritin levels of 3rd-trimester and delivery was significantly higher in the normal group than in the anemia group. Therefore, we suggest for successful pregnancy outcome and delivery differential iron supplementation programs will be carried out with individual Pregnant women on the basis of pre-Pregnancy nutrition. (Korean J Community Nutrition 10(6) : $860\∼868$, 2005)

• Journal of Nutrition and Health
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• v.38 no.7
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• pp.578-585
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• 2005

Maternal zinc deficiency is relatively common worldwide, but its consequences for pregnancy outcome are not established. The purpose of this study was to examine the effect of zinc status in the second trimester on pregnancy outcome. Subjects were 248 pregnant Korean women (25-28 wk gestation). Cord blood was collected from subgroup of 69 women and pregnancy outcome data were obtained from 185 babies. Anthropometry measurement, dietary intake, and biochemical characteristics of pregnancy and cord serum substances were measured. The subjects were divided into quartiles on the basis of maternal serum Zn concentration; $ZnQ_1$ (< 25 percentile), $ZnQ_2$ ($26\~50$ percentile), $ZnQ_3$ ($51\~75$ percentile), and $ZnQ_4$ ($76\~100$ percentile). Zn groups were compared in terms of various maternal factors, concentrations of cord serum substances, and pregnancy outcome. Maternal serum Zn concentration was $118.4\;{\pm}\;35.5\;{\mu}g/dl$ as mean. Intake of Zn was lower than Korean RDA. The rate of Zn deficiency among all subjects was $8.5\%$. Maternal serum Zn levels belonged to normal range. Cord serum Zn level was about $154.7\%$ of maternal serum level. Intakes of energy, calcium, iron, folic acid, and riboflavin did not meet the Korean RDA for pregnant women by gestational age. The mean birth weight of neonates is 3083 $\pm$ 697 g, of whom $9.1\%$ were of low birth weight (< 2,500 g). Maternal serum Zn level was positively correlated with pre-pregnancy weight, pre-pregnancy body mass index, and vitamin C intake (p < 0.05). $ZnQ_1$ group had significantly lower maternal serum iron concentration and higher cord serum cholesterol than those in other groups. Maternal serum Zn level, cord serum Zn level, and dietary Zn intake were no related to the pregnancy outcome. The birth weight had a correlation with the maternal hemoglobin and albumin concentration. In conclusion, at this study, we could not find the association with maternal Zn status in 2nd trimester and pregnancy outcome.

• Clinical and Experimental Pediatrics
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• v.58 no.8
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• pp.283-287
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• 2015

Purpose: We assessed the relationships between iron and vitamin D statuses in breastfed infants and their mothers and evaluated the determinants of iron and vitamin D deficiencies in breastfed infants. Methods: Seventy breastfed infants aged 4-24 months and their mothers participated in this study from February 2012 to May 2013. Complete blood counts, total iron binding capacity, and levels of C-reactive protein, iron, ferritin, calcium, phosphate, alkaline phosphatase, and 25-hydroxyvitamin D (25(OH)D) in infants and their mothers were measured. Results: A history of maternal prepregnancy anemia was associated with lower ferritin and 25(OH)D levels in both infants and their mothers. The 25(OH)D level of infants correlated with maternal 25(OH) D levels. The independent risk factors for iron deficiency in breastfed infants were the duration of breastfeeding (odds ratio [OR], 6.54; 95% confidence interval [CI], 1.09-39.2; P=0.04) and infant body weight (OR, 2.65; 95% CI, 1.07-6.56; P=0.04). The determinants for vitamin D deficiency were the infant's age (OR, 0.15; 95% CI, 0.02-0.97; P=0.046) and maternal 25(OH)D level (OR, 0.74; 95% CI, 0.59-0.92; P=0.01). Conclusion: A maternal history of prepregnancy anemia requiring iron therapy was associated with lower current ferritin and 25(OH)D levels in both infants and their mothers. Therefore, physicians should monitor not only iron but also vitamin D levels in infants who are breastfed by mothers who had prepregnancy anemia.

• Korean Journal of Community Nutrition
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• v.9 no.2
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• pp.142-150
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• 2004

To increase both iron and enhancers for iron absorption through diets should be a basic strategy to sufficiently provide increased iron for pregnancy. Previous studies reported that iron intakes of Korean pregnant women were short and their iron status deteriorated as pregnancy progressed. However, there is little data about the bioavailability of dietary iron during pregnancy. Therefore, this study was conducted to determine the changes of dietary iron intakes, its bioavailability and iron status during pregnancy longitudinally in Korean women. A total of 151 pregnant women in their first trimester of pregnancy voluntarily participated. Among them, 72 women finished the research protocol during the second trimester and 55 did it during the third trimester. Dietary intakes of total iron, both non-heme and heme iron, as well as enhancers, both MPF (meat, poulty, and fish) and vitamin C, increased significantly as pregnancy progressed. As the results, bioavailability of dietary iron and iron absorbed increased significantly as pregnancy progressed. However, the amount of iron absorbed at each trimester did not meet considerably the iron needed during pregnancy. All five indices examined in the study, Hb level, Hct, serum concentrations of ferritin and sTfR (soluble transferrin receptor), and sTfR: ferritin ratio, showed that iron status of the subjects deteriorated as pregnancy progressed. The rate of anemia of the subjects increased as pregnancy progressed although more than 80% of the subjects took iron supplements after the 20th week of pregnancy. These results imply that it is needed to provide more iron especially, heme iron and dietary enhancers to prevent the deterioration of iron status during pregnancy. Future research on bioavailability of supplemental iron should be performed to determine the iron balance precisely.

• Journal of Nutrition and Health
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• v.31 no.8
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• pp.1270-1282
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• 1998

The purpose of this research is to compare the effdct of the new weekly iron supplementation on maternal iron and zinc nutritional status with the effect of the present daily iron supplementation. To assess the iron ad zinc status of rpegant women visiting public health center in Ulsan, interview for dietary survey and general aspect of each subject was given and biochemical analysis of blood and urine was performed. The study subjects were divided to two groups randomly, but the subjects whose Hgb level was very low were allocated in daily group ethically because theeffect of weekly supplementation was not yet established as safety. Daily group received 80mg elemental Fe(250mg Fe as ferrous sulfate) per day for 100days, while weekly group received 160mg elemental Fe once a week for 15 weeks. After treatement, Hgb(p<0.01), Hct(p<0.01) , serum iron(p<0.05) and serum ferritin(p<0.001) in weekly group but RBC, Hgb , Hct , serum iron and serum iron and serum ferritin increased slightly. After correction for the initial Hgb by including it in the MANIVA, the difference in treatment effects of Hgb and TIBC between groups was statistically significant. The effect of weekly vs, daily iron supplementation program on zinc status was also studied. The difference in treatment effect between two groups was, however, not sifnificant. It is concluded that once weekly rion supplementation program in pregnant women was less effectgive to improve the iron status than daily iron supplementation program. However, because the weekly dose prevented a decline in Hgb as well as in ferritin, itw effect was positive , given the fact that non-supplemented women almost always exhibit a sifnificant drop in Hgb values. It seems that it will improve the iron status well if the amount or frequency of supplements is to be adjusted . Biweekly supplementation of a different dose or antother type of iron supplement, such as through a gastric delivery system, might be better.

• Nutrition Research and Practice
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• v.5 no.1
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• pp.52-59
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• 2011

The purpose of this study was to investigate how advanced maternal age influences lifestyle, nutrient intake, iron status, and pregnancy outcomes in pregnant women. The subjects of this study were 112 pregnant women who were receiving prenatal care at gynecologists located in Seoul. The subjects were divided into two groups according to their ages: those over age 35 were the advanced age group of pregnant women (AP) and those under age 35 were the young age group of pregnant women (YP). General factors, nutrient intakes, iron status, and pregnancy outcomes of the two groups were then compared. It was found that 72.5% of the YP group and 51.2% of the AP group had pre-pregnancy alcohol drinking experience; indicating that the YP group had more pre-pregnancy alcohol consumption than the AP group (P<0.05). The only difference found in nutrient intake between the two groups was their niacin intakes which were $16.83{\pm}8.20\;mg$/day and $13.76{\pm}5.28\;mg$/day, respectively. When gestational age was shorter than 38.7 weeks, the average infant birth weight was $2.95{\pm}0.08\;kg$, and when gestational age was longer than 40 weeks, it averaged at about $3.42{\pm}0.08\;kg$. In other words, as gestational age increased, infant birth weight increased (P<0.0001), and when maternal weight increased more than 15 kg, the infant birth weight increased significantly (P<0.05). In conclusion, in order to secure healthy human resources, with respect to advanced aged women, it is necessary to intervene by promoting daily habits that consist of strategic increases in folate and calcium intake along with appropriate amounts of exercise.