Abstract
BackgroundIron supplementation is a common recommendation for pregnant women to prevent iron deficiency during pregnancy. There is an increasing concern about excessive iron consumption as a general iron prophylaxis by pregnant women without any due consideration about their dietary iron intake or iron status. Our present study investigated the association between total iron intake from diet and supplements and fetal growth in 337 pregnant women at mid-pregnancy in South Korea.MethodsIron intake from diet and supplements was examined by a 24-hour recall method. Subjects were divided into three groups based on tertiles of total iron intake levels. Fetal biometry was assessed by ultrasonography at mid-pregnancy.ResultsAbout 99% of the non-supplement users had iron intake below the recommended nutrient intake (RNI) for pregnant women (24 mg), whereas 64.9% of supplement users had iron intake above the upper level (UL) (45 mg). In the babies of mothers in the third tertile of iron intake (>17.04 mg), biparietal diameter, abdominal circumference, and femur length were lower by 0.41 cm (P =0.019), 0.41 cm (P = 0.027), and 0.07 cm (P = 0.051), respectively, than the babies of mothers in the second tertile of iron intake (11.49 ~ 17.04 mg).ConclusionThese results suggest that excessive maternal iron intake at mid-pregnancy is associated with reduced fetal growth. Iron supplementation for pregnant women should be individualized according to their iron status. Appropriate diet education is needed for pregnant women so that they can consume adequate amounts of iron from food and supplements.
Highlights
Iron supplementation is a common recommendation for pregnant women to prevent iron deficiency during pregnancy
Maternal iron status has been a critical factor for pregnancy outcomes, because maternal anemia as well as iron deficiency increases the risk of adverse pregnancy outcomes such as preterm delivery [1] and low birth weight [2]
Fetal biometry and fetal growth according to tertiles of iron intake levels In the babies of mothers in the third tertile of iron intake (>17.04 mg), biparietal diameter, abdominal circumference, and femur length were lower by 0.41 cm (P =0.019), 0.41 cm (P = 0.027), and 0.07 cm (P = 0.051), respectively, than the babies of mothers in the second tertile of iron intake (11.49 ~ 17.04 mg) (Table 4)
Summary
Iron supplementation is a common recommendation for pregnant women to prevent iron deficiency during pregnancy. Our present study investigated the association between total iron intake from diet and supplements and fetal growth in 337 pregnant women at mid-pregnancy in South Korea. Until the past 10 years or so, the risk of iron deficiency in Korean pregnant women was high with a prevalence of ~20% [5,6] and a number of reports are available on inverse association between maternal iron status and pregnancy outcomes [7,8,9,10]. There has been an increasing concern that pregnant women in Korea might be consuming excessive iron from supplements without considering their dietary iron intake or iron status. A possible explanation for this negative association is that excessive iron could lead to oxidative damage [21] and decrease in the absorption of copper and zinc [22], which are the important micronutrients for fetal growth
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