ABSTRACT
Objective: To determine baseline iron and oxidative status in a
cohort of pregnant women before iron supplementation in our setting. Background: Screening of iron deficiency before supplementation during
pregnancy has been scarce. Therefore, following routine iron supplementation
confounding results might be found in outcomes of groups of patients
considered. Taking in account that body/serum iron status is reportedly linked
to maternal oxidative status, we aimed to associate assessment of baseline iron
and oxidative status of women in need of oral supplementation during pregnancy. Methods: This is a cross-sectional
study concerning 74 women attending antenatal care at the University Clinics of
Kinshasa from September 2017 throughout June 2018, with a singleton pregnancy
not exceeding 19 weeks, regardless of age and parity. Variables of the study
included sociodemographic and anthropometric ones along with parameters of iron
status (hemoglobin, hematocrit, ferritin, serum iron, transferrin and iron
saturation capacity). Oxidative status was assessed using superoxide dismutase
(SOD) and uric acid as antioxidants, while oxidant agents were oxidized LDL and
blood glucose (beside serum iron and ferritin). According to local standards
anemia was defined as hemoglobin < 10 g/L and
pathologic serum ferritin as < 15 ng/ml. For statistical calculations we used
t-test, chi-square test and Pearson’s correlation test, the significance being
stated at p ≤ 0.05. Results: At recruitment (15.9 ± 1.7 9 week gestational age) mean hemoglobin value
of the overall study group was 10.3 ± 1.5 g/dl. Anemia was diagnosed to 39
women that represented 52.2% of the study group, most of anemic women belonging
to low socioeconomic sub-group (69.2% vs 29%; P < 0.001). The majority was
para 2, with average weight of 70.2 ± 14.5 Kg (P not significant between
sub-groups) and BMI of 26 ± 5.2 Kg/m2 (P < 0.01). The proportion
of obeses was
18.9%. The proportion of intestinal parasitosis was significantly higher among anemic
women (61.5% vs 34.3%; P < 0.02) that had lower alimentary iron intake (22.8
± 4.9 gr/day vs 31.4 ± 9.5 gr; P < 0.001). Of markers of iron status serum
ferritin and iron were lower in anemic women (7.5 ± 3.9 ng/ml vs 35.7 ± 17.1
ng/ml; P < 0.001 and 52.7 ± 38.9 μg/dl vs 96.2 ± 41.8 μg/dl, respectively.
Both sub-groups were similar in serum transferrin. As of markers of oxidative
stress anemic women had significantly higher superoxide dismutases (SOD)
(1056.4 ± 762.1 UI/L vs 682.6 ± 543.9 UI/L (P < 0.02) and oxidizedd anti LDL
Ac (439.6 ± 209.5 UI/L vs 192.8 ± 136.3 UI/L (P < 0.001). Serum iron,
ferritin, SOD and oxidized LDL were more likely to assess iron and oxidative
status in our setting. Conclusion: The rate of anemic mothers found in our study (52.2%) has been quite
constant in our setting for years, meaning endemicity. Serum iron and ferritin
were significantly lower in anemic women, which is supportive of routine iron
supplementation during pregnancy. Significantly higher level of SOD and
oxidized LDL in anemic women suggests that maternal anemia may count into
oxidative stress likely to be found in these women.