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The erythrocyte incorporation of absorbed non-haem iron in pregnant women

Published online by Cambridge University Press:  09 March 2007

Paul G. Whittaker*
Affiliation:
Department of Obstetrics and Gynaecology, University of Newcastle upon Tyne, Royal Victoria Infirmary, Newcastle, Tyne and Wear NE1 4LP, UK
Jon F.R. Barrett
Affiliation:
Department of Obstetrics and Gynaecology, University of Newcastle upon Tyne, Royal Victoria Infirmary, Newcastle, Tyne and Wear NE1 4LP, UK
Tom Lind
Affiliation:
Department of Obstetrics and Gynaecology, University of Newcastle upon Tyne, Royal Victoria Infirmary, Newcastle, Tyne and Wear NE1 4LP, UK
*
*Corresponding author: Dr Paul G. Whittaker, present address 7905 Winston Rd, Philadelphia, PA 19118, USA, fax +1 215 753 7441, email [email protected]
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Abstract

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Studies of Fe absorption in pregnancy often make unfounded assumptions of erythrocyte incorporation. Therefore, we measured the absorption and utilisation of Fe during early and late pregnancy by the erythrocyte incorporation of two stable isotopes. 8·5 mg 57Fe (oral) and 0·5 mg 58Fe (intravenous) were given to five non-pregnant women, to five women in early gestation (12 weeks) and five women in late gestation (36 weeks). The stable isotope ratios in whole blood 14 d later were measured by MS. Together with estimation of body Fe mass, this enabled the calculation of Fe absorption and erythrocyte incorporation. In non-pregnant women, Fe absorption averaged 20·3 (range 10·2–34·3) %. It was not significantly different in early pregnancy (11·8 (range, 4·4–24·8) %), but during late pregnancy Fe absorption increased to 59·0 (range 38·2–77·2) %. All non-pregnant and early-pregnancy subjects had normal Fe status, but two women in late pregnancy had evidence of Fe insufficiency. During early and late pregnancy, mean erythrocyte incorporation was 63·4 (SD 12·1) % AND 71·0 (sd 10·4) % respectively, significantly reduced (P=0·003) compared with non-pregnant subjects (90·1 (sd 6·0) %). Decreased erythrocyte incorporation of absorbed Fe in early pregnancy is compatible with reduced Fe demand and low oral absorption. However, during late pregnancy decreased erythrocyte incorporation associated with high absorption and Fe insufficiency is different from the high erythrocyte incorporation which occurs in non-pregnant Fe-deficient women. This suggests that part of the aetiology of Fe deficiency during pregnancy may be the reduction of Fe utilisation.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2001

References

Barrett, JFR, Whittaker, PG, Williams, JG & Lind, T (1992) Absorption of non-haem iron in normal women measured by incorporation of two stable isotopes into erythrocytes. Clinical Science 83, 213219.Google Scholar
Barrett, JFR, Whittaker, PG, Williams, JG & Lind, T (1994) Absorption of non-haem iron from food during normal pregnancy. British Medical Journal 309, 7982.Google Scholar
Beguin, Y, Lipscei, G, Thoumsin, H & Fillet, G (1991) Blunted erythropoietin production and decreased erythropoiesis in early pregnancy. Blood 78, 8993.Google Scholar
Bothwell, TH, Charlton, RW, Cook, JD & Finch, CA (1979) Iron Metabolism in Man Oxford: Blackwell.Google Scholar
Centers for Disease Control (1989) Criteria for anemia in children and childbearing-aged women. Morbidity and Mortality Weekly Report 38, 400404.Google Scholar
Commission on Atomic Weights and Isotopic Abundances (1997) Isotopic composition of the elements 1997. http://www.physics.curtin.edu.au/IUPAC/Final97.doc.Google Scholar
Cook, JD, Dassenko, SA & Lynch, SR (1991) Assessment of the role of nonheme-iron availability in iron balance. American Journal of Clinical Nutrition 54, 717722.CrossRefGoogle ScholarPubMed
Dyer, NC & Brill, AB (1972) Use of the stable tracers 58-Fe and 50-Cr for the study of iron utilization in pregnant women. In Nuclear Activation in the Life Sciences, pp. 469477 [Anonymous, , editor]. Vienna: IAEA.Google Scholar
Fairweather-Tait, SJ & Minski, MJ (1986) Studies on iron availability in man, using stable isotope techniques. British Journal of Nutrition 55, 279285.Google Scholar
Finch, CA (1970) Ferrokinetics in man. Medicine 49, 1753.Google Scholar
Fomon, SJ, Janghorbani, M, Ting, BTG, Ziegler, EE, Rogers, RR, Nelson, SE, Ostedgaard, LS & Edwards, BB (1988) Erythrocyte incorporation of ingested 58-iron by infants. Pediatric Research 24, 2024.Google Scholar
Hahn, PF, Carothers, EL, Darby, WJ, Martin, M, Sheppard, CW & Cannon, RO (1951) Iron metabolism in early pregnancy as studied with the radioactive isotope Fe59. American Journal of Obstetrics and Gynecology 61, 477486.CrossRefGoogle Scholar
Heinrich, HC (1970) Intestinal iron absorption in man – methods of measurement, dose relationships, diagnostic and therapeutic applications. In Iron Deficiency. Pathogenesis. Clinical Aspects. Therapy, pp. 213296 [Hallberg, L, Harwerth, HG and Vannoti, A, editors]. London: Academic Press.Google Scholar
Heinrich, HC & Fischer, R (1982) Correlation of post-absorptive serum iron increase and erythrocyte 59-Fe incorporation with the whole body retention of absorbed 59-Fe. Klinische Wochenschrift 60, 14931496.Google Scholar
Hosain, F, Marsaglia, G & Finch, CA (1967) Blood ferrokinetics in normal man. Journal of Clinical Investigation 46, 19.Google Scholar
Howells, MR, Jones, SE, Napier, JA, Saunders, K & Cavill, I (1986) Erythropoiesis in pregnancy. British Journal of Haematology 64, 595599.Google Scholar
Kastenmayer, P, Davidsson, L, Galan, P, Cherouvrier, F, Hercberg, S & Hurrell, RF (1994) A double stable isotope technique for measuring iron absorption in infants. British Journal of Nutrition 71, 411424.Google Scholar
Larsen, L & Milman, N (1975) Normal iron absorption determined by means of whole body counting and red cell incorporation of 59Fe. Acta Medica Scandinavica 198, 271274.CrossRefGoogle ScholarPubMed
Lehmann, WD, Fischer, R & Heinrich, HC (1988) Iron absorption in man calculated from erythrocyte incorporation of the stable isotope iron-54 determined by fast atom bombardment mass spectrometry. Analytical Biochemistry 172, 151159.CrossRefGoogle ScholarPubMed
Lunn, JA, Richmond, J, Simpson, JD, Leask, JD & Tothill, P (1967) Comparison of three radioactive methods of measuring iron absorption. British Medical Journal 3, 331333.CrossRefGoogle Scholar
Miller, JC & Miller, JM (1993) Statistics for Analytical Chemistry 3rd ed., pp. 115116.Chichester: Ellis Harwood Ltd.Google Scholar
O'Brien, KO, Zavaletta, N, Caulfield, LE, Yang, DX & Abrams, SA (1999) Influence of prenatal iron and zinc supplements on supplemental iron absorption, red blood cell iron incorporation, and iron status in pregnant Peruvian women. American Journal of Clinical Nutrition 69, 509515.Google ScholarPubMed
Paintin, DB (1963) The haematocrit ratio in pregnancy. Journal of Obstetrics and Gynaecology of the British Commonwealth 70, 807810.Google Scholar
Svanberg, B (1975) Iron absorption in early pregnancy – a study of the absorption of non-haeme iron and ferrous iron in early pregnancy. Acta Obstetricia Gynecologica Scandinavica 48, Suppl., 6986.Google Scholar
Svanberg, B, Arvidsson, B, Bjorn-Rasmussen, E, Hallberg, L, Rossander, L & Swolin, B (1975 a) Dietary iron absorption in pregnancy – a longitudinal study with repeated measurements of non-haeme iron absorption from the whole diet. Acta Obstetricia Gynecologica Scandinavica 48, Suppl., 4386.Google Scholar
Svanberg, B, Arvidsson, B, Norrby, A, Rybo, G & Solvell, L (1975 a) Absorption of supplemental iron during pregnancy – a longitudinal study with repeated bone-marrow studies and absorption measurements. Acta Obstetricia Gynecologica Scandinavica 48, Suppl., 87108.CrossRefGoogle ScholarPubMed
Whittaker, PG, Barrett, JFR & Williams, JG (1992) Precise determination of iron isotope ratios in whole blood using ICP-MS. Journal of Analytical Atomic Spectrometry 7, 109113.CrossRefGoogle Scholar
Whittaker, PG & Lind, T (1993) The intravascular mass of albumin during human pregnancy. British Journal of Obstetrics and Gynaecology 100, 587592.Google Scholar
Whittaker, PG, Lind, T & Williams, JG (1991) Iron absorption during normal human pregnancy: a study using stable isotopes. British Journal of Nutrition 65, 457463.Google Scholar
Whittaker, PG, MacPhail, S & Lind, T (1996) Serial hematologic changes and pregnancy outcome. Obstetrics and Gynecology 88, 3339.CrossRefGoogle ScholarPubMed