The Influence of Nutritional Supplementation for Iron Deficiency Anemia on Pregnancies Associated with SARS-CoV-2 Infection.

Mihaela Uta,Marius Craina,Lavinia Stelea,Adelina Geanina Mocanu,Cosmin Citu,Adrian Gluhovschi,Alin Popescu,George Dahma,Catalin Dumitru,Felix Bratosin,Elena Bernad,Radu Neamtu

doi:10.3390/nu14040836

Mihaela Uta, Marius Craina + Show 10 more

Open Access

https://doi.org/10.3390/nu14040836

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Abstract

Anemia is a very common occurrence during pregnancy, with important variations during each trimester. Anemia was also considered as a risk factor for severity and negative outcomes in patients with SARS-CoV-2 infection. As the COVID-19 pandemic poses a significant threat for pregnant women in terms of infection risk and access to care, we developed a study to determine the impact of nutritional supplementation for iron deficiency anemia in correlation with the status of SARS-CoV-2 infection. In a case-control design, we identified 446 pregnancies that matched our inclusion criteria from the hospital database. The cases and controls were stratified by SARS-CoV-2 infection history to observe the association between exposure and outcomes in both the mother and the newborn. A total of 95 pregnant women were diagnosed with COVID-19, having a significantly higher proportion of iron deficiency anemia. Low birth weight, prematurity, and lower APGAR scores were statistically more often occurring in the COVID-19 group. Birth weight showed a wide variation by nutritional supplementation during pregnancy. A daily combination of iron and folate was the optimal choice to normalize the weight at birth. The complete blood count and laboratory studies for iron deficiency showed significantly decreased levels in association with SARS-CoV-2 exposure. Puerperal infection, emergency c-section, and small for gestational age were strongly associated with anemia in patients with COVID-19. It is imperative to screen for iron and folate deficiency in pregnancies at risk for complications, and it is recommended to supplement the nutritional intake of these two to promote the normal development and growth of the newborn and avoid multiple complications during pregnancy in the COVID-19 pandemic setting.

Highlights

We aimed to identify potential unwanted outcomes of anemia during pregnancy that might be associated with maternal exposure to SARS-CoV-2 and determine the difference made by nutritional supplementation in these pregnancies
The stratification by COVID-19 status determined a significant difference in the number of newborns identified with anemia
The primary merit of this study is represented by a comparison of laboratory profiles of pregnant women by the trimester of COVID-19 diagnosis to determine how SARS-CoV-2 is involved in existent alterations

Summary

Introduction

According to the World Health Organization, more than 2 billion people worldwide suffer from iron deficiency, and more than 38% of pregnant women worldwide suffer from anemia during pregnancy [1]. Especially in women of childbearing age, and is mostly caused by menstrual blood loss and a lack of iron-rich foods consumed orally [6]. Women need iron and folate throughout pregnancy to satisfy their own demands and those of the growing fetus. Iron deficiency anemia is defined by a low serum ferritin level, typically 15 μg/L. Fetal growth requires around 800–850 mg of iron [8]

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