Abstract
Pregnancy is a physiological state that demands higher level of nutrients, including vitamins and minerals, for the growth and maintenance of the fetus. Iron deficiency is a part of most common diet deficiencies in pregnancy and has high clinical significance leading to the development of syderopenic anemia and its consequences for mother and child, such as higher risk of perinatal death, susceptibility to infection, intra-uteral growth inhibition, prematurity and low birth weight. Hence, iron supplementation is recommended for pregnant women; however dietary intake of iron from most commercially available formulas is often insufficient due to iron-poor bioavailability, or have undesired side-effects in the gastrointestinal tract, resulting in a discouraging and distrustful attitude to such treatment. The results of numerous studies indicate that diet supplementation with lactoferrin (LTF), an iron-binding protein, may be advantageous in prophylaxis and treatment of iron deficiency anemia. LTF, administered orally, normalizes iron homeostasis, not only by facilitating iron absorption, but also by inhibiting inflammatory processes responsible for anemia of chronic diseases, characterized by a functional iron deficit for physiological processes. LTF also protects against infections and inflammatory complications, caused by diagnostic surgical interventions in pregnant women. Beneficial, multidirectional actions of LTF during pregnancy encompass, in addition, inhibition of oxidative stress, normalization of intestine and genital tract microbiota and carbohydrate-lipid metabolism, protection of intestine barrier function, promotion of wound healing, as well as hypotensive, analgesic and antistress actions. Bovine lactoferrin (BLTF) is readily available on the nutritional market and generally recognized as safe (GRAS) for use in human diet.
Highlights
Pregnancy is associated with major physiological changes which ensure the best environmental conditions for embryo and fetus for growth and development
Evidence exists that iron deficiency anemia (IDA) in pregnancy is associated with increased maternal morbidity and mortality as well as an increased risk of adverse outcomes in the offspring [4,5]
In this article we review some of the pre-clinical and clinical studies on LTF, taking into consideration plausible regulatory mechanisms of its action, as well as practical aspects of its application as a diet supplement in pregnant women with IDA, both in healthy pregnancy and pregnancy affected by infections and inflammations of various etiology
Summary
Pregnancy is associated with major physiological changes which ensure the best environmental conditions for embryo and fetus for growth and development. Due to the major clinical significance of nutrient deficiencies, their supplementation in the diet is highly recommended, yet needs to be carefully crafted. Exacerbation of oxidative stress and inflammatory states in pregnancy, due to application of elemental iron, especially when given in high doses (orally or parenterally), may increase risk of serious systemic events such as premature delivery, preeclampsia, glucose intolerance/gestational diabetes, low birth weight and cognitive defects in newborns [1,6,7,8,9,10,11,12]. As a multifunctional immune modulator, antioxidant agent and regulator of intestinal iron absorption, LTF has already been shown to be effective, with a safety profile for prophylaxis and treatment of some anemia and chronic inflammation in pregnant women. In this article we review some of the pre-clinical and clinical studies on LTF, taking into consideration plausible regulatory mechanisms of its action, as well as practical aspects of its application as a diet supplement in pregnant women with IDA, both in healthy pregnancy and pregnancy affected by infections and inflammations of various etiology
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