Abstract
Low-grade inflammation is often present in people living with obesity. Inflammation can impact iron uptake and metabolism through elevation of hepcidin levels. Obesity is a major public health issue globally, with pregnant women often affected by the condition. Maternal obesity is associated with increased pregnancy risks including iron deficiency (ID) and iron-deficiency anaemia (IDA)—conditions already highly prevalent in pregnant women and their newborns. This comprehensive review assesses whether the inflammatory state induced by obesity could contribute to an increased incidence of ID/IDA in pregnant women and their children. We discuss the challenges in accurate measurement of iron status in the presence of inflammation, and available iron repletion strategies and their effectiveness in pregnant women living with obesity. We suggest that pre-pregnancy obesity and overweight/obese pregnancies carry a greater risk of ID/IDA for the mother during pregnancy and postpartum period, as well as for the baby. We propose iron status and weight gain during pregnancy should be monitored more closely in women who are living with overweight or obesity.
Highlights
This review explores inflammation as a potential underlying cause of iron deficiency (ID) or iron-deficiency anaemia (IDA) in pregnant women who are living with overweight or obesity
The aim of this review is to summarise results from studies conducted worldwide in the last ten years that report measurements of iron and inflammatory status in pregnant women who are living with overweight or obesity
In a study of 245 pregnant women living with obesity and 245 normal-weight pregnant women, Flynn et al [86] reported significantly elevated CRP and Interleukin 6 (IL-6) levels in obese vs. lean pregnant women, with no difference in serum ferritin or serum hepcidin levels at 15–18 weeks gestation, suggesting that at least at this stage of pregnancy maternal hepcidin is not driven by inflammation
Summary
This review explores inflammation as a potential underlying cause of iron deficiency (ID) or iron-deficiency anaemia (IDA) in pregnant women who are living with overweight or obesity. The aim of this review is to summarise results from studies conducted worldwide in the last ten years that report measurements of iron and inflammatory status in pregnant women who are living with overweight or obesity. For the investigations on the effect of inflammation in pregnant women who are living with overweight or obesity on iron status, the Pubmed library was used. The following search terms were used: 1. Overweight AND mother* AND anaem* AND inflamm*. The search yielded 339 studies; 305 duplicates and 20 studies that did not focus on pregnancy were removed, leaving 14 that are discussed below in greater detail
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