• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.370-374
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• 2018

Background: Iron is an essential element for women of reproductive age, especially in the period before and during the pregnancy. This study investigates the consumption of iron to prevent iron deficiency anemia among pregnant women visiting Neyshabur healthcare centers based on the theory of planned behavior. Methods: In this experimental study, data were collected through a questionnaire survey. It included 160 pregnant women who were receiving maternity services at twelve healthcare centers in the city of Neyshabur in Iran between 2015 and 2017. The participants' demographic and anthropometric characteristics, Using the theory of planned behavior, and blood lab examination results, including ferritin levels were measured and the data were analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Results: The average scores of knowledge, attitude, perceived behavioral control, subjective norms, and intention categories for the intervention group were meaningfully increased after the participants received education on iron supplementation (P<0.05). However, these changes were not found to be significant in the control group (P>0.05). No statistically significant difference was obtained in the subjective norms category between the two groups after the education intervention (P=0.92). Conclusion: Based on the experimental effects of education encouraging iron supplementation in pregnant women, it is suggested that workshops promoting iron supplementation should be conducted in health centers with the aim of preventing widespread iron deficiency anemia.

• 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 Human Ecology
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• v.4 no.1
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• pp.36-45
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• 2001

This study was performed to determine the changes of maternal iron status during pregnancy cross sectionally, and to evaluate the appropriateness of the cut-off points of hemoglobin (Hb). hematocrit (Hct), serum transferrin receptor (sTfR) and sTfR : ferritin ratio for assessing iron deficiency status based on serum ferritin level (< 12${\mu}g$/L). Serum Hb concentrations in the first trimester were significantly higher (p < 0.05) than those in the second and third trimester. Serum levels of iron and ferritin in the third trimester were significantly lower (p < 0.05) than those in the first and second trimester. On the other hand, sTfR:ferritin ratios in the third trimester were significantly higher (p < 0.05) than those in the first and second trimester. sTfR concentrations did not change significantly during pregnancy. The appropriate cut-off points of Hb were 11.5g/dL for whole period of pregnancy. 12.0g/dL for 1st trimester. and 11.5g/dL for both 2nd and 3rd trimester. The good cut-off points of Hct were 34% for whole period of pregnancy. 36% for 1st trimester. and 34% for both 2nd and 3rd trimester The suitable cut-off points of TIBC were 400${\mu}g$/dL for whole period of pregnancy. 360${\mu}g$/dL for 1st trimester, and 400${\mu}g$/dL for both 2nd and 3rd trimester. Any cut-off point of sTfR could not be selected because of its low sensitivity and specificity. The proper cut-off point of sTfR : ferritin ratio was 600 or 650 for all the periods determined except the first trimester. In conclusion, there were no reliable cut-off levels of sTfR and those of sTfR : ferritin ratio showed low specificity. The cut-off values of Hb and Hct for assessing iron deficiency were slightly higher than the values used to evaluate anemia. Thus, if appropriate cut-off levels were applied, Hb. Hct, or TIBC might be useful indices for evaluating iron deficiency as well as anemia.

• Journal of the East Asian Society of Dietary Life
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• v.10 no.6
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• pp.495-506
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• 2000

The purpose of this study was to assess the nutritional status of iron and magnesium and the effect of von supplementation during 8 weeks(from 20 to 28 weeks of gestation) on serum iron and magnesium status of 31 pregnant women in Kyunsin area. The age, weight, and height of the subjects before pregnancy were investigated by questionnaires. At 20 and 28 weeks of gestation, data for food and nutrient intake were obtained by questionnaires and serum sample was obtained. According to the frequency of iron supplementation, subjects were divided into two groups(4$\geq$/wk) The mean iron supplementation of 5 $\geq$/wk group(63.mg/day) was significantly higher than 4$_2$ intakes were much less than the Korean RDA. Especially, calcium, iron and magnesium intakes showed half the levels compared with Korean RDA. At 28 weeks of gestation the serum total protein(p<0.001), albumin(p<0.01) and globulin(p<0.001) were significantly decreased. Total iron binding capacity(TIBC) was significantly increased(P<0.001), but serum ferritin(p<0.01) and magnesium(p<0.01) concentrations were significantly decreased. However, even 28 weeks of gestation 5$\geq$/wk group showed higher serum iron and ferritin concentration and lower TIBC than 4$\geq$/wk group. Therefore, iron supplementation should be conducted with concerning the mineral balance like magnesium.

• 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 Yeungnam Medical Science
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• v.11 no.2
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• pp.352-362
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• 1994

To evaluate the effects of pregnancy-induced hypertension (PIH) to the iron status of fetuses, umbilical cord blood of 35 newborn infants borne by PIH mothers and of 37 normal term infants delivered at Yeungnam University Hospital from September 1, 1993 to September 30, 1994, were studied. The serum hemoglobin concentration of women with PIH was significantly higher than normal full-term pregnant women. There was no significant difference in serum hemoglobin concetration between women with PIH and normal full-term pregnant women and their newborn infants. There was no significant difference in serum hemoglobin concentration beween infants of women with PIH and normal full-term infants. The serum iron concentration of newborn infants of women with PIH was higher and the serum ferritin concentration of newborn infants of women with PIH was lower than normal full-term infants, but there were no significant difference between the two groups. The serum total iron-binding capactity and unsaturated iron-binding capacity of infants of women with PIH were significantly higher than normal full-term infants. The newborn infants of PIH women seemed that they might have occult depletion of iron store and need meticulous follow up during early neonatal period.

• Journal of Nutrition and Health
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• v.44 no.1
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• pp.5-15
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• 2011

Although iron is an essential mineral, excess iron intake during pregnancy may increase oxidative stress in tissues. This study was conducted to investigate the effects of iron overload during pregnancy on iron status and oxidative stress in maternal rats. Ten week-old female Sprague-Dawley rats were mated with male rats. Non-pregnant (control) and pregnant rats were fed diets containing normal Fe (35 mg/kg diet), high Fe (350 mg/kg diet), or excess Fe (1,050 mg/kg diet) during pregnancy. Rats were sacrificed on pregnancy day 19. No significant difference in weight gain, diet intake, or litter size was observed according to iron intake levels. Furthermore, serum iron, hemoglobin, and hematocrit were not different among the rats administered the three levels of Fe both in the control and pregnant groups. However, the iron levels were lower in pregnant rats than those in the control. The liver and spleen iron contents increased significantly in the excess Fe group. An increase in liver ferritin levels with increasing iron intake was observed. Protein carbonyl content, as a marker of oxidative stress, increased significantly in liver with increasing iron intake but not malondialdehyde. Glutathione peroxidase activity in the liver of pregnant rats fed excess iron decreased significantly. Bcl-2 protein expression in the liver declined remarkably with increasing maternal iron intake in pregnant rats. Taken together, iron overload during pregnancy had little effect on hematology. However, the deposits of iron in the liver and the decline in antioxidant enzyme activity implied increased oxidative stress in tissues of the excess Fe group. These results suggest that excess iron intake during pregnancy increases oxidative stress in maternal tissues and may also affect fetal tissues.