Association of pregestational obesity with anemia during pregnancy: A literature review

Abstract

Relevance: Оbеse pregnant women have а mild inflammatory response associated with hepcidin overexpression. Inflammation affects iron metabolism by increasing hepcidin levels. Obesity and anemia are serious problems worldwide; expectant mothers often suffer from these conditions. Gravidas with obesity tend to gain more weight during pregnancy than gravidas with normal body mass index. Obesity before pregnancy is associated with a high risk in pregnancy, including hypoferremia and anemia due to iron deficiency, which are already common between expectant mother and their neonates. This review considers obesity-associated inflammatory mediator activation as a potential primary cause of iron deficiency (ID) or iron deficiency anemia (IDA) in obese pregnant women.The review aimed to summarize the current studies reporting the measurement of molecular markers of iron metabolism and inflammatory mediators in pregnant women with pregestational obesity. Methods: This review included all types of publications in English and Russian on anemia and obesity in pregnancy, published from March 2012 to March 2022. The literature search was performed in Medline, Scopus, Web of Science, Google Scholar, PubMed, and CyberLeninka databases by the following keywords: “pregnancy,” “iron deficiency,” “anemia,” “overweight,” “obesity,” “inflammation,” and “body mass index.”Results: This review assesses whether obesity-induced inflammation may contribute to the increased incidence of ID/IDA in pregnant women. Despite numerous studies, the effect of maternal weight on the risk of ID/IDA during pregnancy remains unclear. Iron status metabolism markers against inflammation are considered. PR-pregnancy obesity carries a greater risk of developing ID/IDA during pregnancy and the postnatal period for the mother and the baby. Conclusions: Thus, a more careful study of iron levels by trimester is required. The introduction of clearly defined procedures for trimester valuation of iron and inflammatory status in antenatal and postpartum consultations is necessary.