The iron status of pregnant women with hemoglobinopathies

doi:10.1016/0002-9378(72)90653-9

American Journal of Obstetrics and Gynecology

Volume 113, Issue 7, 1 August 1972, Pages 895-900

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Abstract

In a study of the iron status of 15 pregnant women with hemoglobinopathies, eight had no stainable iron in the bone marrow, despite the absence of acute or chronic blood loss, intercurrent infection, or infestation with parasites; in three, iron deficiency was present before the sixteenth week of pregnancy. This study shows that in our population the prevention of iron deficiency is important in pregnant women with hemoglobinopathies.

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Cited by (11)

Iron profile of pregnant sickle cell anemia patients in Odisha, India
2023, Hematology, Transfusion and Cell Therapy
Citation Excerpt :
In an earlier study by Oluboyde O.A, the difference in levels of serum ferritin between pregnant and non-pregnant HbSS and HbSC women was not significant. 29 A few other studies also found no source of iron in the bone marrow of pregnant mothers with SCD.30,31 Such differences may be due to variations in methodology and samples studied, or the difference in patterns of iron intake in the study subjects.
During pregnancy, the iron requirement increases to meet the optimal growth of the fetus and prevent iron deficiency anemia-related complications in the mother. However, in sickle cell disease (SCD) primarily due to repeated blood transfusions and hemolysis-induced recycling of iron, its supplementation during pregnancy remains questionable and may be harmful.
Twenty-five pregnant women with homozygous SCD and 25 pregnant women with normal hemoglobin variants were included as cases and control, respectively. Pregnancy and sickle cell anemia (SCA) were diagnosed using standard protocols. The serum iron, serum ferritin, total iron-binding capacity (TIBC), percentage transferrin saturation and C-reactive protein were estimated, as per the manufacturer's protocol. The complete blood count was performed. The unpaired ‘t-test’ was performed using the SPSS v23.0 and the principal component analysis (PCA) was performed using the online software MetaboAnalyst for statistical analysis.
The studied cases had significantly lower mean hemoglobin and higher mean corpuscular volume (MCV), compared to controls. The mean serum-iron, serum-ferritin and percentage transferrin-saturation in the cases were significantly higher than that of the controls, while the TIBC was lower in the cases (p < 0.0001). The mean level of serum iron, ferritin, percentage transferrin saturation and TIBC were 309.44 ± 122.40mcg/dl, 860.36 ± 624.64ng/ml, 42.6 ± 17.30% and 241.32 ± 96.30 mcg/dl, respectively, in the cases and 95.36 ± 41.90mcg/dl, 122.28 ± 49.70ng/ml, 15.83 ± 3.10% and 492.6 ± 149.40mcg/dl in the controls, respectively. Higher MCV, mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) with lower hemoglobin (Hb) were noted in the cases. The PCA revealed that the cases were more heterogeneous in terms of the variability of the iron status and hematological indices than the controls.
The current study shows iron sufficiency in most cases of pregnancy with SCA and suggests that evaluation of iron status must be made before initiating iron prophylaxis in pregnant women with SCA, especially in regions having a high prevalence of sickle cell hemoglobinopathy.
Antenatal iron supplementation in sickle cell disease
1987, International Journal of Gynecology and Obstetrics
Fourteen pregnant women with sickle cell disease (11 SS and 3 SC) were randomized into two groups to receive routine antenatal supplementation either with ferrous gluconate or with placebo tablets. Their hemoglobin levels and bone marrow iron content were determined prenatally and 6 weeks post partum. The fetal weights and the incidence of pain crisis in both groups were recorded. Using an iron content grading from 0 to 5, no marrow of any subject showed iron depletion. The placebo group showed an aggregate postnatal loss of 4 grades of iron repletion while the iron supplemented group showed an aggregate gain of 2 grades. There were no significant differences between the birth weight or the incidence of pain crises in both groups.
We conclude that routine iron supplementation is not justified in pregnant women with sickle cell disease, as it would tend to increase already adequate or excessive iron body stores. We recommend that a clear need for iron should be established before iron supplementation is prescribed to them.
Iron stores in pregnant women with sickle cell disease: a systematic review
2020, BMC Pregnancy and Childbirth
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2018, BMC Pregnancy and Childbirth
The Iron Status of Sickle Cell Anaemia Patients in Ilorin, North Central Nigeria
2015, Advances in Hematology
Iron in sickle cell disease: A review why less is better
2003, American Journal of Hematology

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The iron status of pregnant women with hemoglobinopathies

Abstract

Lancet

J. Obstet. Gynaecol. Br. Commonw

J. Obstet. Gynaecol. Br. Commonw

J. Obstet. Gynaecol. Br. Commonw

J. Lab. Clin. Med