Prelatent Iron Deficiency Research Articles

Nutritional status of flexitarians compared to vegans and omnivores - a cross-sectional pilot study

BackgroundIn the Western world, there has been a notable rise in the popularity of plant-based, meat-reduced flexitarian diets. Nevertheless, there is insufficient data on the nutritional status of individuals following this dietary pattern. The aim of this study was to investigate the intake and endogenous status of various nutrients in a healthy German adult study population consisting of flexitarians (FXs), vegans (Vs) and omnivores (OMNs).MethodsIn this cross-sectional study, dietary intake of 94 non-smoking adults (32 FXs, 33 Vs, 29 OMNs) between 25 and 45 years of age was assessed using 3-day dietary records. In addition, blood samples were collected to determine different endogenous nutrient status markers.Results32%, 82% and 24% of the FXs, Vs, and OMNs respectively reported using dietary supplements. In the FXs, intake of total energy as well as macronutrients and most micronutrients were within the reference range. FXs had higher intakes of fiber, retinol-equ., ascorbic acid, folate-equ., tocopherol-equ., calcium, and magnesium compared to OMNs. However, cobalamin intake in FXs (2.12 µg/d) was below the reference (4 µg/d). Based on 4cB12, 13% of FXs showed a cobalamin undersupply [< -0.5 to -2.5] compared to 10% of OMNs, and 9% of Vs. The median 25(OH)D serum concentrations in FXs, Vs and OMNs were 46.6, 55.6, and 59.6 nmol/L. The prevalence of an insufficient/deficient vitamin-D status [< 49.9 nmol 25(OH)D/L] was highest in FXs (53%), followed by Vs (34%) and OMNs (27%). In FXs and Vs, the supplement takers had better cobalamin and vitamin-D status than non-supplement takers. Anemia and depleted iron stores were found only occasionally in all groups. In women, the prevalence of pre-latent iron deficiency and iron deficiency was highest in FXs (67%) compared to Vs (61%) and OMNs (54%).ConclusionOur findings indicated that all three diets delivered sufficient amounts of most macro- and micronutrients. However, deficiencies in cobalamin, vitamin-D, and iron status were common across all diets. Further studies are needed to investigate the nutrient supply status and health consequences of meat-reduced plant-based diets. The study was registered in the German Clinical Trial Register (number: DRKS 00019887, data: 08.01.2020).

Iron Deficiency in Adolescent and Young Adult German Athletes-A Retrospective Study.

Iron deficiency is a common phenomenon in sports and may lead to impaired physical performance. The aim of the study was to determine the frequency of iron deficiency in competitive athletes and to discuss the resulting consequences. The data of 629 athletes (339 male, 290 female) who presented for their annual basic sports medicine examination were investigated. Depending on age (&lt;14 years, 15-17 years, ≥18-30 years), four groups ((I.) normal hemoglobin (Hb) and ferritin level (≥30 ng/mL for adults and 15-18-year-olds; ≥20 ng/mL, respectively, ≥15 ng/mL for adolescents and children), (II.) prelatent iron deficiency (ID) (normal Hb, low ferritin), (III.) latent ID (additionally elevated soluble transferrin receptor or decreased transferrin saturation) and (IV.) manifest anemia) were distinguished. In addition, the iron status and exercise capacity of different types of sports were compared. Overall we found an iron deficiency of 10.9% in male (mainly in adolescence) and 35.9% in female athletes (emphasized in adolescence and young adulthood). There were no significant differences in iron status in regard to the different sport types or in maximum performance for the different groups of iron deficiency. Adolescent and female athletes are more likely to have an iron deficiency. Therapy concepts for athletes therefore should pay attention to iron-rich diets.

Incidence of iron deficiency and its pathogenesis in patients with H. pylori infection

606 patients (405 men and 201 women) with HP infection were examined, 121 (m 67; f 54) found clinical or clinical and laboratory signs of iron deficiency, the frequency of iron deficiency in the examined group of patients with HP was 19.9% (16.8-23.3; CI 95%). 25 (20.7%) were diagnosed with anaemia, 66 (54.5%) patients had a latent deficit of iron, 30 patients (24.8%) showed only a decrease in TS, which is typical for pre-latent iron deficiency. 38 (31.4%) patients had a «true» iron deficiency, 44 (36.4%) patients had a combined variant of iron deficiency, and 39 (32.2%) iron deficiency developed as a result of chronic inflammation. There was a significant difference in the level of hepcidin in patients with different options for iron deficiency. In patients with “isolated” iron deficiency, it was 12.4 ± 2.3 ng/ml, vs 48.2-± 20.2 ng/ml vs 189.7 ± 31.1 ng / ml in patients with a combined pathogenic variant of iron deficiency and in patients with iron deficiency of chronic inflammation, respectively.

Anemias and their relationship with nutrient status

Nutritional anemias are among the most common nutrient deficiencies in the world. Anemia syndrome was found in about 2 billion persons, and the annual mortality rate due to anemia nowadays reaches 1 million persons. The main cause for the development of anemia of alimentary origin is the imbalance of the diet by micronutrients, especially supply of iron as well as vitamins B12 and B9. The problem of the abundance of anemia is also characteristic ofUkraine and has its own regional features; this requires research, analysis and identification of the main causes of anemia associated with alimentary status. In order to assess the actual diet and differentiation of anemias by type we used a calculation method realizing a retrospective method of analysis of the frequency of food consumption and biochemical and hematological methods of blood tests. Analysis of the actual diet of the population revealed an imbalance and irrationality of nutrition which created preconditions for the formation of eating disorders associated with the development of anemia of alimentary origin. According to the results of the analysis of the actual diet 77.3 % of persons with iron deficiency anemia were found, folate deficiency anemia was found in 13.6 % of individuals, and cyanocobalamin deficiency anemia was found in 9.1 % of persons. According to the results of the research some sexual peculiarities of the microelement status for iron were revealed among the examined individuals, in particular, within the female group pre-latent iron deficiency was observed in 13.8 % of persons, and in the male one it was found in 41.7 % of ones; latent deficiency was found in 32.8 % of persons and in 22.9 % of persons, respectively, but iron deficiency anemia was revealed in 19.8 % persons and 2.1 % of persons, respectively. The number of individuals with anemia detected in the biochemical study of serum by iron content confirmed the results of the assessment of the actual diet; these numbers were equal to 32.9 % and 31.1 %, respectively.

ANEMIA DAN DEFISIENSI BESI PADA SISWA SLTP NEGERI I CURUG, TANGERANG

A research was conducted to 69 female students from a junior high school (SLtP) Negeri I Curug, tangerang aged 12–14 yearsto obtain percentages of anemia and iron deficiency in female adolescents. Anemia was found on 10.2% of the students, with 4.3%of normocytic normochromic anemia and 5.8% of microcytic hypochromic anemia. Microcytic hypochromic erythrocytes was foundon 21.7% of the subjects which consist of 2.9% iron deficiency anemia, 1.4% phase 2 iron deficiency (latent) with possibility ofhemoglobinopathy, and 2.9% phase 1 iron deficiency (pre-latent) with possibility of hemoglobinopathy. Anemia without iron deficiencywith possibility of chronic diseases and/or hemoglobinopathy was 2.9%, and without anemia nor iron deficiency but with possibility ofhemoglobinopathy was 11.6%. Iron deficiency was found among 26.1% of subjects which consist of 11.6% pre-latent iron deficiency,8.7% latent iron deficiency, and 5.8% iron deficiency anemia with 2.9% and 2.9% were normocytic normochromic anemia andmicrocytic hypochromic anemia, respectively.

Early Diagnosis of Iron Deficiency in School Children: A Qatari Experience

Objective: Iron deficiency still remains the most common nutritional deficiency throughout the world and is the leading cause of anaemia in children. Early recognition of iron deficiency, even before the development of anaemia is crucial to prevent the systemic complications of this disease. Methods: Ninety-seven school children between 5 and 16 years were stratified into prelatent iron deficiency (10 cases), latent iron deficiency (14 cases), overt iron deficiency anemia (13 cases), and controls (60 cases). All hemograms were performed on the same day of collection using the same Sysmex XE-2100 analyzer with reticulocyte indices included. Biochemical markers such serum iron, total iron binding capacity and percent saturation (calculated) in addition to serum ferritin and serum transferrin receptors were simultaneously measured. Data analysis was done using ANOVA test, generalized linear regression, and ROC curve. Results: Our study indicates that a panel based on hematologic parameters including reticulocyte hemoglobin at a cut off of ≤27 and ≤25.6, serum transferrin receptors at a cut off >0.48 and >0.68, red cell distribution width at a cut off >13.8 and >16.8 may provide an alternative to the traditional biochemical panels for the diagnosis of latent iron deficiency and overt iron deficiency anemia respectively. Conclusion: Whenever iron deficiency is thought of, a hemogram including reticulocyte hemoglobin and serum transferrin receptors would be the adequate diagnostic panel obviating the need for a more extensive one. These parameters should always be interpreted in the clinical context involving dietary habits, social standard as well as family history.

Cardiac functions in children with iron deficiency anemia

In this study, we aimed to assess the effects of iron deficiency (ID) on cardiac functions with M-mode, pulse Doppler, and tissue Doppler and to compare the findings with healthy individuals. Twenty one children with only ID (prelatent ID + latent ID + manifest ID/anemia) and completely healthy 23 children were included in the study. Of all patients, complete blood counts were studied, and serum iron (Fe), iron binding capacity (FeBC), and ferritin levels were measured. Echocardiographic assessment was performed for those who were diagnosed with Fe deficiency at the beginning of the study and after there covery of anemia and once at the beginning of the study for those who were healthy. There were significant differences between control group values and pre-treatment values of patients with manifest ID in terms of hemoglobin (Hgb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width (RDW), ferritin, Fe, FeBC, aortic diameter (AD), and left atrial diameter (LAD). Between the pre- and post-treatment values of manifest ID (anemia) patients, there were significant differences in terms Hgb, Hct, MCV, MCH, MCHC, ferritin, Fe, FeBC, AD, LAD, left ventricular end systolic diameter, left ventricular end diastolic diameter, septal thickness, posterior wall thickness, ejection fraction, fractional short time, mitral, tricuspid, and septal isovolumetric relaxation time and septal isovolumetric contraction time. Diastolic and systolic cardiac dysfunction occurs at the stage of manifest ID where the value of Hgb decreased and these changes recover with treatment.

Dietary iron intake and deficiency in elite women volleyball players

Volleyball practice requires repeated impacts on arms and feet caused by vertical jumps, falls, auctions, sudden and rapid changes of direction, which is why might raise us problems in the metabolism of iron (Fe) and the recommended intake of 18 mg/day (in the women in general), is not sufficient to meet the needs of the players of volleyball female (JVF). We analyzed the FS and IST of 10 JVF a team of Spanish SuperLeague (26.6 ± 5.9 years and height 178.05 ± 8.7 cm) in two moments of the season: Week 0 (pre-start of preseason) and week 11 (after 11 weeks of training and 6 games of the regular season). Also calculated Fe intake in this period with consumption frequency questionnaire developed and tested with food dietary records of 7 days. We observed that an intake of 25.8 mg/day of dietary Fe is not sufficient to prevent 30% of the JVF suffer pre-latent iron deficiency and 20% latent deficit (pre-anemia). It could be recommended conducting periodic blood analytical and a food education, teaching which foods containing a high content of Fe-type heme, and the factors that can interfere with absorption.

Biorhythms of functional activity of phagocytes in iron deficiency.

Biorhythms of absorption capacity of neutrophils and monocytes were studied in women with latent iron deficiency. We revealed disorders in circadian organization of the mononuclear phagocyte system and decreased reserve capacity of nonspecific organism's resistance against the background of tissue iron deficiency. Informative value of desynchronosis in circadian structure of the phagocyte absorption capacity as the early marker of prelatent iron deficiency was established.

Iron supplementation in athletes. Current recommendations.

There is still debate in the literature on whether or not endurance athletes tend to have low iron stores. In this article, we propose that endurance athletes really are at risk of becoming iron deficient due to an imbalance between absorption of dietary iron and exercise-induced iron loss. The purpose of this article is to present a critical review of the literature on iron supplementation in sport. The effect of iron deficiency on performance, its diagnosis and suggestions for treatment are also discussed. Studies of the nutritional status of athletes in various disciplines have shown that male, but not female, athletes clearly achieve the recommended dietary intake of iron (10 to 15 mg/day). This reflects the situation in the general population, with menstruating women being the main risk group for mild iron deficiency, even in developed countries. Whereas the benefit of iron supplementation in athletes with iron deficiency anaemia is well established, this is apparently not true for non-anaemic athletes who have exhausted iron stores alone (prelatent iron deficiency); most of the studies in the literature show no significant changes due to supplementation in the physical capacity of athletes with prelatent iron deficiency. However, the treatment protocols used in some of these studies do not meet the general recommendations for the optimal clinical management of iron deficiency, that is, with respect to adequate daily dosage, mode of administration and treatment period. For future studies, we recommend a prolonged treatment period (> or = 3 months) with standardised conditions of administration (use of a pharmaceutical iron preparation with known high bioavailability and a dosage of ferrous (Fe++) iron 100 mg/day, taken on an empty stomach). Currently, decisions regarding iron supplementation are best made on the basis of taking care of individual athletes. We believe that there are sufficient arguments to support controlled iron supplementation in all athletes with low serum ferritin levels. Firstly, the development of iron deficiency is prevented. Secondly, the nonspecific upregulation of intestinal metal ion absorption is reverted to normal, thus limiting the hyperabsorption of potentially toxic lead and cadmium even in individuals with mild iron deficiency.

Consequences of 6 weeks of strength training on red cell O2 transport and iron status

Effects of endurance training on O2 transport and on iron status are well documented in the literature. Only a few data are available concerning the consequences of strenuous anaerobic muscular exercise on red cell function. This study was performed to test the influence of strength training alone on parameters of red cell O2 transport and iron status. Twelve healthy untrained males participated in a strength-training programme of 2-h sessions four times a week lasting 6 weeks. After 6 weeks a small but significant reduction of haemoglobin (Hb; -5.4 g.l-1) was found (p less than 0.05). Mean red cell volume did not change, but a pronounced decrease of mean cell Hb concentration (from 329.2 g.l-1, SE 2.5 to 309.8 g.l-1, SE 1.2; p less than 0.001) and mean corpuscular Hb (from 29.6 pg, SE 0.4 to 27.7 pg, SE 0.3; p less than 0.01) was observed. Serum ferritin decreased significantly by 35% (p less than 0.01); transferrin, serum iron and iron saturation of transferrin were unaltered. Serum haptoglobin concentration was diminished significantly by 30.5% (p less than 0.01). The reticulocyte count had already increased after 3 weeks of training (p less than 0.05) and remained elevated during the following weeks. Strength training had no significant influence on the O2 partial pressure at which Hb under standard conditions was 50% saturated, red cell 2,3-diphosphoglycerate and ATP concentration as well as on erythrocytic glutamate-oxalacetate transaminase activity. The data demonstrate that mechanical stress of red cells due to the activation of large muscle masses led to increased intravascular haemolysis, accompanied by a slightly elevated erythropoiesis, which had no detectable influence on Hb-O2 affinity. Training caused an initial depletion of body iron stores (prelatent iron deficiency). Although Hb had decreased by the end of the training phase a true "sports anaemia" could not be detected.

Iron status in Winter Olympic sports

Iron status was surveyed amongst 92 Winter Olympic sport athletes from Nordic and Alpine skiing, figure and speed skating and ice hockey. Haemoglobin and serum ferritin values were obtained by physicians as part of a monitoring programme, since iron deficiency would have an adverse effect on maximal performance. Four (7%) of 56 men were anaemic (Hb less than 14.0 g dl-1) and three (8%) of 36 women had haemoglobin values less than 12.0 g dl-1. Nine men (16%) and 14 women (39%) had prelatent iron deficiency (serum ferritin less than 30 ng ml-1). Ice hockey had the lowest while Nordic skiing had the highest incidence of sub-optimal iron status. A total of 50% of Nordic women skiers had prelatent iron deficiency and 7% were anaemic. An equal percentage of women speed skaters were low in serum ferritin as well. Only one of 20 male ice hockey players was low in serum ferritin. These results suggest there would be value in instituting screening procedures for iron status in Winter Olympic Sports.

The response of runners to arduous triathlon competition.

As very few of the competitors in a triathlon are truly specialist in more than one of the three disciplines, high levels of physical (and mental) stress may result during the course of the event. We investigated some of the physiological responses occurring in runners participating in an "Iron Man" triathlon consisting of canoeing (20 km), cycling (90 km) and running (42 km), in that sequence. Twenty-one male entrants volunteered as subjects for the study. Prior to the competition, maximal oxygen consumption (VO2max) was determined. Basal venous blood samples were collected on the day prior to the competition and post-exercise venous blood samples were collected within 5 minutes of completion of the race. Serum iron was significantly reduced from a mean basal value of 20.6 mumol X l-1 to a mean value of 8.4 mumol X l-1 after the race. Cortisol levels showed a 3 fold increase after the race. Gross VO2max (l X min-1) and mass standardised VO2max (ml X min-1 X kg-1) were both negatively correlated to cortisol levels after the race (p less than 0.05). Total performance time was not related to gross VO2max (l X min-1) but was well correlated to mass corrected VO2max (ml X min-1 X kg-1). The marked fall in serum iron may have been related to heavy sweating or prelatent iron deficiency. Chronic iron deficiency (without frank anaemia) can impair physical performance, although we were unable to show any significant correlation between serum iron level after the race and time taken to complete the event.(ABSTRACT TRUNCATED AT 250 WORDS)

Training for cross-country skiing and iron status

Effects of iron supplements and training for cross-country skiing on hematological and iron status were studied in nine men and ten women from the U. S. Nordic ski team. Four men and five women received a multiple vitamin, multiple mineral supplement containing 18 mg iron for 8 months while five men and five women received a placebo. Fasting blood samples were taken from all skiers prior to supplementation (May) and in August, November, and January. Hemoglobin, hematocrit, plasma iron, total iron binding capacity (TIBC), percentage of transferrin saturation, serum ferritin, free erythrocyte porphyrin, and haptoglobin were measured on each sample. Hemoglobin, hematocrit, and TIBC were higher in November when both men and women skiers trained at altitude than in August. In January TIBC was further increased, haptoglobin was increased, hemoglobin for the men fell below May levels, and hematocrit returned to May levels. Skiers receiving iron had lower TIBC levels in November and January than the placebo group. Six women and two men had ferritin levels below 28 ng X ml-1, which suggests prelatent iron deficiency. Free erythrocyte porphyrin levels above 100 micrograms X dl-1 RBC were found in all skiers at some point during training. The results suggest that multivitamin, multimineral supplements containing iron have little effect on the iron status of cross-country skiers.

Developmental Changes in Serum Ferritin Concentration of Dairy Calves

Serum ferritin concentration of nursing calves was measured by a two-site immunoradiometric assay to assess developmental changes and to evaluate relationships of serum ferritin with iron-related blood characteristics. Serum ferritin concentration of calves was low at birth and elevated slightly at 3 days of age. From 1 wk of age onward, serum ferritin concentration of untreated calves and calves fed only whole milk for 4 wk decreased and remained low throughout the nursing period. This finding almost coincided with hematological characteristics. However, that nearly normal hematological measures and weight gain persisted and that they did not develop any anemic symptom indicate that serum ferritin concentration is more sensitive than other hematological characteristics to iron depletion. However, serum ferritin concentration of calves administered 130mg of ferrous fumarate (40mg iron) daily from 3 to 22 days of age or injected with 4ml of iron-dextran intramuscularly (400mg iron) at 3 days and 2 wk of age increased sharply just after treatment and persisted high for 2 to 6 wk of age. However, there was large variation between animals for serum ferritin concentration. Thus, it seems likely that serum ferritin concentration is an index for monitoring prelatent iron deficiency of calves.

Intestinal iron absorption under the influence of available storage iron and erythroblastic hyperplasia

A high negative correlation (coefficient similar to 0.9) between increased 59Fe absorption from a diagnostic 0.56 mg 59Fe2+ dose and the depletion of available storage iron was observed in menstruating and pregnant women, fullterm and premature infants, blood donors, patients with infections, inflammations, tumors, hepatic cirrhosis, gastric surgery, increased urogenital or gastrointestinal blood loss. The increased diagnostic 59Fe2+ absorption is a reliable and sensitive indicator of at least depleted iron stores or prelatent iron deficiency as caused by iron malnutrition or maldigestion, increased iron requirement in pregnancy, infancy, urogenital or gastrointestinal blood loss. Although the messenger system which signalyzes the depletion of iron stores to the iron absorbing enterocytes of the duodenal and jejunal mucosa is not yet known available storage iron seems to control intestinal iron absorption under normal and the great majority o pathological condition in humans. Anemia per se or high erythropoietin levels in blood do not influence iron absorption since patients with even severe erythroblastic hypoplasia, aplastic anemia and megaloblastic anemia due to vitamin B12 deficiency absorb iron according to their iron stores. An only mild hyperplasia of the erythropoietic system in the bone marrow does also not effect iron absorption which was still under the control of available storage iron in patients with hereditary spherocytosis, nonspherocytic congenital hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency, acquired hemolytic anemia and vitamin B12 deficiency induced megaloblastic anemia..

Absorption of inorganic and food iron in children with heterozygous and homozygous beta-thalassemia.

The intestinal absorption of 59Fe from a diagnostic 10 μmole (0.56 mg) 59Fe2+ test dose and 5 mg Fe equivalents of 59Fe-labeled pork, hog liver and hemoglobin was measured with a 4 π geometry whole-body radioactivity detector with liquid organic scintillator and the results compared with the stainable amounts of diffuse cytoplasmatic (non-heme) storage iron in the bone marrow macrophages, serum iron concentrations and total iron-binding capacity, erythropoietic activity and other hematological parameters. Children with mild hypochromic, microcytic anemia due to heterozygous β-thalassemia absorbed normal amounts of 59Fe from the diagnostic dose of 59Fe2+ if their bone marrow macrophages contained normal or mildly increased amounts of diffuse cytoplasmatic storage iron. Depleted iron stores also caused increased absorption of diagnostic 59Fe in children with heterozygous β-thalassemia, so that prelatent iron deficiency can be diagnosed by measurement of increased iron absorption.

59Fe 2+- and hemoglobin- 59Fe absorption in human beings do not require gastric juice or intrinsic factor

The intestinal 59Fe absorption from 10-μmole (=0.56 mg) 59Fe 2+ and hemoglobin- 59Fe as well as from 5.0-mg hemoglobin- 59Fe doses was measured with the 59Fe-absorption whole-body retention test in normal volunteers and in vitamin-B 12-treated pernicious anemia patients with gastric atrophy and absolute intrinsic-factor deficiency. A completely normal 59Fe absorption from ferrous iron and hemoglobin iron at the 0.56-mg iron level was observed in all the patients without gastric juice. At the 5.0-mg iron dose level hemoglobin- 59Fe was even better (2-fold) absorbed in patients with absolute intrinsic-factor deficiency and a purified hog intrinsic-factor concentrate of known potency did not influence the already doubled hemoglobin- 59Fe absorption. Depleted iron stores in prelatent iron deficiency resulted in a 4-fold increase of 59Fe 2+ absorption and a 50% increase of hemoglobin- 59Fe absorption also in patients without gastric juice and without intrinsic factor. Gastric juice or a gastric intrinsic factor are therefore not required for intestinal ferrous iron or hemoglobin-iron absorption in humans.

Role of red cell distribution width (RDW) in the detection of iron deficiency anaemia in pregnancy within the first 20 weeks of gestation

Iron deficiency anemia is common problem during pregnancy. Red cell size variation (anisocytosis) is the earliest morphologic changes in iron deficiency anemia. Red cell distribution width is a quantitative measure of red cell size variation and it can give the idea of early iron deficiency before other test to become positive. 190 pregnant women were included in this study. Red cell distribution width was compared between iron deficient & non-iron deficient pregnant women. Red cell distribution width also compared with Hb level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and peripheral blood film in prelatent iron deficiency, latent iron deficiency, mild and moderate iron deficiency anemia. Red cell distribution width had sensitivity 82.3% and specificity 97.4%. Whereas Hb level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and peripheral blood film all had 56.6%, 29.2%, 68.1%, 15% and 38.9% sensitivity but specificity was 90.9%, 98.7%, 83.1%, 96.1% and 98.7% in the detection of iron deficiency. Red cell distribution width appears to be a reliable and useful parameter for detection of iron deficiency during pregnancy.

MOBILISATION OF IRON IN PREGNANCY

Sternal bone-marrow aspirates from pregnant women were stained for storage iron. Hæmatological indicators of iron nutrition were examined throughout the remainder of pregnancy in three groups of women: those with latent or prelatent iron deficiency (as judged by stainable marrow iron) whose iron stores were replenished with parenteral iron and who subsequently were given no supplementary hæmatinics (A) or oral folic acid (B); and those with satisfactory iron stores (C). In group C, low levels of serum-iron developed during pregnancy, and iron-deficiency anæmia developed in some. Hæmatological indicators remained satisfactory in groups A and B, so iron resources in these patients were much greater than the iron content of the bone-marrow indicated. It is suggested that storage iron in the marrow is mobilised early in pregnancy to provide a source of immediately available iron; this mobilisation is achieved, perhaps, by an increase in serum total iron-binding capacity.