Iron and Iodine Status in Pregnant Women from A Developing Country and Its Relation to Pregnancy Outcomes

Birth related complications and comorbidities are highly associated with a poor nutritional status of pregnant women, whereas iron and iodine are among especially important trace elements for healthy maternal and fetal outcomes. The study compares the status of iron, iodine, and related functional parameters in pregnant and non-pregnant women from a developing country and associates the data with pregnancy complications. The concentrations of ferritin, hemoglobin (Hb), total triiodothyronine (TT3), total thyroxine (TT4), and thyroid-stimulating hormone (TSH) were determined in the blood serum of 80 pregnant women at the time of delivery and compared with 40 non-pregnant healthy controls. Spot urine samples were taken to evaluate the urinary iodine concentration (UIC). In pregnant women, ferritin, Hb concentrations, and UIC were significantly lower, and TT4 values were significantly higher compared to controls. Higher Hb levels were tendentially associated with a reduced risk for pregnancy complications (OR = 0.747, CI (95%) 0.556–1.004; p = 0.053). Regarding covariates, only previous miscarriages were marginally associated with pregnancy complications. High consumption of dairy products was associated with lower Hb and ferritin values. Our results suggest that pregnant women from a developing country have lower iron status with Hb levels being possibly associated with pregnancy complications.

[1]  S. Iqbal,et al.  Maternal and neonatal outcomes related to iron supplementation or iron status: a summary of meta-analyses , 2019, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[2]  I. Velasco,et al.  Iodine as Essential Nutrient during the First 1000 Days of Life , 2018, Nutrients.

[3]  W. Teng,et al.  Effect of Iodine Nutrition on Pregnancy Outcomes in an Iodine-Sufficient Area in China , 2017, Biological Trace Element Research.

[4]  Allison L. Fisher,et al.  Iron homeostasis during pregnancy. , 2017, The American journal of clinical nutrition.

[5]  H. Völzke,et al.  Factors affecting sustainable iodine deficiency elimination in Pakistan: A global perspective , 2017, Journal of epidemiology.

[6]  S. Mandel,et al.  2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. , 2011, Thyroid : official journal of the American Thyroid Association.

[7]  J. Coad,et al.  Dairy Product (Calcium) Consumption and Iron Nutrition , 2017 .

[8]  Zhengnan Gao,et al.  Reference Intervals of Thyroid Function During Pregnancy: Self-Sequential Longitudinal Study Versus Cross-Sectional Study. , 2016, Thyroid : official journal of the American Thyroid Association.

[9]  M. Hettiarachchi,et al.  Urinary iodine and thyroid determinants in pregnancy: a follow up study in Sri Lanka , 2016, BMC Pregnancy and Childbirth.

[10]  K. Evenson,et al.  Prevalence of U.S. Pregnant Women Meeting 2015 ACOG Physical Activity Guidelines , 2016, American journal of preventive medicine.

[11]  R. Noor,et al.  Iron Supplementation Affects Hematologic Biomarker Concentrations and Pregnancy Outcomes among Iron-Deficient Tanzanian Women. , 2016, The Journal of nutrition.

[12]  Alison D. Gernand,et al.  Micronutrient deficiencies in pregnancy worldwide: health effects and prevention , 2016, Nature Reviews Endocrinology.

[13]  Arroyo-Helguera Elind,et al.  Trace Elements as Potential Biomarkers of Preeclampsia , 2016 .

[14]  T. Li,et al.  Do women with recurrent miscarriage constitute a high-risk obstetric population? , 2016, Human fertility.

[15]  P. Arosio,et al.  Iron Homeostasis in Health and Disease , 2016, International journal of molecular sciences.

[16]  C. Breymann.  Iron Deficiency Anemia in Pregnancy. , 2013, Seminars in hematology.

[17]  E. Lurbe,et al.  Assessment of ten trace elements in umbilical cord blood and maternal blood: association with birth weight , 2015, Journal of Translational Medicine.

[18]  Z. Rosario,et al.  Association between maternal diet factors and hemoglobin levels, glucose tolerance, blood pressure and gestational age in a Hispanic population. , 2015, Archivos latinoamericanos de nutricion.

[19]  J. Akpotuzor,et al.  Comparative study of some haematological parameters of pregnant women in Akpabuyo local government area of Cross River State, Nigeria , 2015 .

[20]  W. Teng,et al.  Maternal subclinical hypothyroidism, thyroid autoimmunity, and the risk of miscarriage: a prospective cohort study. , 2014, Thyroid : official journal of the American Thyroid Association.

[21]  P. Andersen,et al.  Risk factors for miscarriage from a prevention perspective: a nationwide follow‐up study , 2014, BJOG : an international journal of obstetrics and gynaecology.

[22]  C. Collins,et al.  The effect of nutrition knowledge and dietary iron intake on iron status in young women , 2014, Appetite.

[23]  E. Pearce,et al.  Iodine and pregnancy: a call to action , 2013, The Lancet.

[24]  O. Christiansen,et al.  New insights into mechanisms behind miscarriage , 2013, BMC Medicine.

[25]  K. Caldwell,et al.  Race-ethnicity is related to biomarkers of iron and iodine status after adjusting for sociodemographic and lifestyle variables in NHANES 2003-2006. , 2013, The Journal of nutrition.

[26]  D. McClain,et al.  Iron and diabetes risk. , 2013, Cell metabolism.

[27]  P. Wallemacq,et al.  Iodine and iron status of pregnant women in Lubumbashi, Democratic Republic of Congo , 2013, Public Health Nutrition.

[28]  K. O’Brien,et al.  Pregnancy and iron homeostasis: an update. , 2013, Nutrition reviews.

[29]  F. Azizi,et al.  Variations of urinary iodine during the first trimester of pregnancy in an iodine-replete area. Comparison with non-pregnant women , 2013, Hormones.

[30]  Z. Bhutta,et al.  Routine iron/folate supplementation during pregnancy: effect on maternal anaemia and birth outcomes. , 2012, Paediatric and perinatal epidemiology.

[31]  Mu Li,et al.  The changing epidemiology of iodine deficiency , 2012, Nature Reviews Endocrinology.

[32]  A. Demmouche,et al.  Prevalence of anaemia in pregnant women during the last trimester: consequense for birth weight. , 2011, European review for medical and pharmacological sciences.

[33]  K. Zaletel,et al.  Thyroid function in the third trimester of pregnancy and after delivery in an area of adequate iodine intake , 2011, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[34]  P. Khanna,et al.  Trace Elements in Critical Illness , 2011 .

[35]  R. Negro,et al.  2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. , 2011, Thyroid : official journal of the American Thyroid Association.

[36]  B. Donadille,et al.  Thyroid function at the third trimester of pregnancy in a Northern French population. , 2010, Annales d'endocrinologie.

[37]  I. Egli,et al.  Iron bioavailability and dietary reference values. , 2010, The American journal of clinical nutrition.

[38]  S. Barollo,et al.  Iodine status in pregnancy: role of dietary habits and geographical origin , 2009, Clinical endocrinology.

[39]  J. Sunyer,et al.  Iodine levels and thyroid hormones in healthy pregnant women and birth weight of their offspring. , 2009, European journal of endocrinology.

[40]  N. Moss,et al.  Anemia Prevalence and Risk Factors in Pregnant Women in an Urban Area of Pakistan , 2008, Food and nutrition bulletin.

[41]  L. Højgaard,et al.  Calcium from milk or calcium-fortified foods does not inhibit nonheme-iron absorption from a whole diet consumed over a 4-d period. , 2004, The American journal of clinical nutrition.

[42]  S. Harris.  The effect of calcium consumption on iron absorption and iron status. , 2002, Nutrition in clinical care : an official publication of Tufts University.

[43]  S. Lynch.  The effect of calcium on iron absorption , 2000, Nutrition Research Reviews.