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Iron deficiency in pregnancy

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Pregnancy involves an increased need for iron. Iron supplements suitable in pregnancy contain key nutrients that support the proper development of the foetus and promote normal haematopoiesis in the mother and the baby.

Headaches, weakness, drowsiness and pallor are some typical signs of iron deficiency (sideropenia). Iron is an essential element for many physiological processes in the human body, as it promotes the formation of haemoglobin, ensuring proper oxygenation of the body.

Particularly in women, there are many conditions that can cause considerable loss or consumption of iron, so it is important to keep the amount of iron in the body under control.

The incidence of iron deficiency is more frequent in women than in men, especially during fertile age and pregnancy. In the most developed countries, the incidence of iron deficiency is 3% among adult men, 20% among women and 50% among pregnant women.1

The need for iron

Iron needs to increase exponentially during pregnancy, in particular in the last quarter, to meet the extra demands of the development of the fetoplacental unit. As well as promoting the production of new red blood cells, iron is essential for the foetus to ensure adequate birth weight and promote cognitive development.

A varied and balanced diet is important and this includes the correct daily intake of iron. However, in some cases, the diet is not sufficient to maintain normal iron levels in the body and, for this reason, iron supplementation in pregnancy is recommended by gynaecologists.

During fertile age, women may have low iron levels due to the menstrual cycle, which results in a consistent blood loss (more than 35 ml per month) resulting in iron loss. This means women need to replenish the mineral through the diet.

It is important to remember that 5% of the iron contained in plant foods is absorbed, while the percentage increases to 15-35% in meat foods2​; therefore, in cases where sideropenia is not corrected with nutrition, it is advisable to use food supplement iron-based.

Keeping the values of iron in the blood under control is very important, even for those who do not suffer from anaemia or sideropenia.

Iron never circulates in the blood in free form but must be bound to proteins that prevent it from binding to other molecules. This is because free iron is highly reactive and could react with other substances causing damage to the body.

SIDERAL_iron-deficency_300x250px_04

The values of iron in the body are measured by the analysis of specific proteins that regulate its transport and storage:

1. Sideremia​, that measures the amount of circulating iron bound to transferrin.

2. Transferrin anaemia,​ that measures the amount of transferrin, the protein that transports iron to the organs and tissues where erythropoiesis occurs, or the synthesis of red blood cells.

3. Transferrin saturation​, in adults the optimal situation occurs when the saturation of transferrin is between 20 and 50%.3

4. Ferritinaemia​, which measures the amount of ferritin, a protein that regulates the storage of iron in the liver, muscles and bone marrow.

In addition, for the differential diagnosis between sideropenia and iron deficiency anaemia, a doctor can evaluate these two markers:

Haemoglobin​, a protein most present in the blood and contains iron and is therefore able to bind to oxygen and transport in red blood cells to tissues and elsewhere in the body. Based on WHO recommendations4 ​the accepted values for this protein are as follows:

Man

≥130 g/dL

Woman

≥120 g/dL

 

Pregnant woman

≥110 g/dL

Haematocrit​, a parameter representing the volume of blood (expressed as a percentage) occupied by red blood cells.

These laboratory tests are usually performed when iron deficiency anaemia is suspected or when there is a condition of asthenia and general feeling of weakness characterized by the typical symptoms of iron deficiency. The most common symptoms include:

  1. Pallor
  2. Weakness
  3. Irritability
  4. Dizziness
  5. Fatigue
  6. Cold and shapeless feet and hands
  7. Acceleration of the heartbeat

Pregnancy requires an increased need for iron and therefore increases the likelihood of a deficiency of this essential nutrient, so it is important to monitor haematological levels.

SIDERAL_iron-deficency_300x250px_03

Iron-rich foods such as red meat (turkey, horse, beef), liver, spleen, green leafy vegetables, legumes, wholegrains and oily fish, can be useful. However it can sometimes be necessary to support a diet with dietary supplements.

Iron supplements suitable in pregnancy, usually contain additional nutrients that support the proper development of the foetus and promote normal haematopoiesis (formation of red blood cells) in both mother and baby. The most common nutrients are:

- folic acid and folate (vitamin B9), which promote the growth of maternal tissue during pregnancy and reduce the risk of foetus neural tube defects;

- vitamin B6 (pyridoxine), which promotes the proliferation of white and red blood cells;

- vitamin B12 (cobalamin), which favours new formation of red blood cells;

- vitamin C, which promotes the absorption of iron in the intestine;

- vitamin D, which supports normal bone development.

In other words, iron supplements in pregnancy not only help to maintain normal iron levels in the mother, but provide complete support for the growth and contributes to physical and cognitive development of the baby.

Sucrosomial® technology can be taken at any time during the day (on an empty stomach or with food) without experiencing any discomfort commonly associated with iron intake, such as metallic and unpleasant aftertaste, irritation of the gastric mucosa, nausea or constipation. Sucrosomial® iron promotes the absorption of this important mineral in all situations where there is deficiency or an increased need for iron.

References

Nutritional anaemias: tools for effective prevention and control​ World Health Organization (2017).

Iron nutrition and absorption: dietary factors which impact iron bioavailability​ Monsen E.R. (J Am Diet Assoc. July 1988, 786-90).

Normal Ferritin in a Patient with Iron Deficiency​ Mackie S. and Winkelman J.W. (J Clin Sleep Med. May 2013, 9(5): 511–513).

4​ Nutritional anaemias: tools for effective prevention and control​, World Health Organization (November 2017).

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