Ethnic differences in adverse iron status in early pregnancy: a cross-sectional population-based study

Abstract

We studied ethnic differences in terms of iron status during pregnancy between Dutch women and other ethnicities and explore to what extent these differences can be explained by environmental factors. This cross-sectional population-based study (2002–2006) was embedded in the Generation R study and included a total of 4737 pregnant women from seven ethnic groups (Dutch, Turkish, Moroccan, Cape Verdean, Surinamese-Hindustani, Surinamese-Creole and Antillean). Ethnicity was defined according to the Dutch classification of ethnic background. Ferritin, iron and transferrin were measured in early pregnancy. The overall prevalence of iron deficiency was 7 %, ranging from 4 % in both Dutch and Surinamese-Creoles, to 18 % in Turkish, Moroccan and Surinamese-Hindustani women. Iron overload was most prevalent in Surinamese-Creole (11 %) and Dutch (9 %) women. Socioeconomic factors accounted for 5–36 % of the differences. Income was the strongest socioeconomic factor in the Cape Verdean and Surinamese-Hindustani groups and parity for the Turkish and Moroccan groups. Lifestyle determinants accounted for 8–14 % of the differences. In all groups, the strongest lifestyle factor was folic acid use, being associated with higher iron status. In conclusion, in our population, both iron deficiency and iron overload were common in early pregnancy. Our data suggest that ethnic differences in terms of socioeconomic and lifestyle factors only partly drive the large ethnic differences in iron status. Our data support the development of more specific prevention programmes based on further exploration of socioeconomic inequities, modifiable risk and genetic factors in specific ethnic subgroups, as well as the need for individual screening of iron status before supplementation.

Assurance versus frustration: a retrospective single-center analysis of female patients with acute telogen effluvium

“…Furthermore, it should be emphasized that the PSs of all parameters were around 50%, suggesting a normal distribution, except for iron. The relatively low values of iron PSs might be due to the ethnic tendency of Turkish women toward lower serum iron values 12,13 . However, due to normal mean values, it should be considered that none of the analyzed parameters can directly be accused as the cause of the hair sheddings.…”

An Evaluation of Food and Nutrient Intake among Pregnant Women in The Netherlands: A Systematic Review

“…The mean/median dietary iron intake was between 10.5 and 12.2 mg per day (see Figure 12) [50,57,94]. The iron intakes were above the EAR and below the RDA.…”

“…Looman et al reported an increase in the total iron intake during pregnancy due to an increased intake via supplements [50]. Three studies reported on iron supplement use, indicating that 18 and 36% of the women used iron-containing supplements during pregnancy [65,94,95]. The mean iron status was 17 and 22 µmol/L [65,96].…”

“…a = median with 25th and 75th percentiles; b = mean with standard deviation (SD); c = median with 90% range. Generation R study[94]. GLIMP2 study[50].…”

Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4‐year‐old children

“…Thus, as delays in cognitive and behavioural functions may or may not co‐occur, with varying consequences for children, it is worth assessing each aspect individually. As it is known that many biological and lifestyle conditions could influence maternal iron status (Hanson, 2001 ; Quezada‐Pinedo et al, 2022 ; Rasmussen et al, 2005 ), the present study aimed to assess the effect of prenatal iron supplementation in non‐anaemic pregnant women by adjusting the dose to the mother's actual iron needs on their children's risk of behavioural problems at 4 years of age.…”