The effects of iron supplementation on serum copper and zinc levels in pregnant women with high‐normal hemoglobin

Ziaei, Saeideh; Janghorban, Roksana; Shariatdoust, Sosan; Faghihzadeh, Soghrat

doi:10.1016/j.ijgo.2007.07.026

Cited by 37 publications

(30 citation statements)

References 16 publications

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“…On the other hand, O'Brien et al [23] reported that administration of 60 mg of iron and 250 μg of folate without zinc supplementation during pregnancy caused a reduction of plasma zinc concentration; they therefore recommended the inclusion of zinc in prenatal supplements in order to reduce the potential of iron supplementation to adversely influence zinc status. Iron supplementation in pregnant women with haemoglobin greater than 13.2 g/dL reduces serum levels of copper and zinc [26]. Generally, zinc and copper deficiencies during pregnancy are associated with preeclampsia, low birth weight and poor foetal outcomes [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Anaemia, Zinc and Copper Deficiencies Among Pregnant Women in Central Sudan

Bushra

Elhassan

Ali³

et al. 2009

Biol Trace Elem Res

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Anaemia is a widespread problem in many parts of the world especially in tropic areas. Among pregnant women, it has negative consequences on maternal and perinatal outcomes. A cross-sectional study was conducted to investigate the prevalence of anaemia, iron, zinc and copper deficiencies among pregnant women in Wad Medani hospital, central Sudan and to examine the relationship of these micronutrients with haemoglobin (Hb) levels. One hundred four (52.5%) out of 200 pregnant women had anaemia (Hb < 11 gm/dl) and 3 (1.5) % had severe anaemia (Hb < 7 gm/dl). Iron deficiency (S-ferritin < 15 µg/l), iron deficiency anaemia (<11 gm/dl and S-ferritin < 15 µg/l) were prevalent in 25 (12.5%) and 13 (6.5%) of these women, respectively. Ninety (45.0%) and eight (4.0%) of these women had zinc (<80 µg/ml) and copper (<80 µg/ml) deficiency, respectively. In 24 (12.0%) of these women, there were ≥2 deficiencies of these elements. S-copper was not [corrected] significantly lower in patients with anaemia. While age, parity, gestational age, ferritin, zinc and copper were not predictors for anaemia, women who practiced pica were at higher risk for anaemia (OR = 3.4, 95% CI = 1.4-7.9, P = 0.004). Gestational age was significantly inversely correlated with haemoglobin (r = 0.161, P = 0.03), S-ferritin (r = 0.285, P = 0.001) and S-zinc (r = 0.166, P = 0.02). Thus, dietary and supplement interventions are required to prevent and control anaemia in this setting. Further research is needed.

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Section: Discussionmentioning

confidence: 99%

Anaemia, Zinc and Copper Deficiencies Among Pregnant Women in Central Sudan

Bushra

Elhassan

Ali³

et al. 2009

Biol Trace Elem Res

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“…Third, iron overload may impair the systemic response to inflammation and infection (1), which could be associated with adverse birth outcomes (50,51). Finally, there is also the potential for excess iron to alter the maternal gut microbiome (52) as well as increase the risk of copper and zinc deficiency (53), which may have implications for birth outcomes (54,55).…”

Section: Potential Mechanisms For Adverse Effects Of Excess Iron Durimentioning

confidence: 99%

U-shaped curve for risk associated with maternal hemoglobin, iron status, or iron supplementation

Dewey

Oaks

2017

The American Journal of Clinical Nutrition

193

224

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Both iron deficiency (ID) and excess can lead to impaired health status. There is substantial evidence of a U-shaped curve between the risk of adverse birth outcomes and maternal hemoglobin concentrations during pregnancy; however, it is unclear whether those relations are attributable to conditions of low and high iron status or to other mechanisms. We summarized current evidence from human studies regarding the association between birth outcomes and maternal hemoglobin concentrations or iron status. We also reviewed effects of iron supplementation on birth outcomes among women at low risk of ID and the potential mechanisms for adverse effects of high iron status during pregnancy. Overall, we confirmed a U-shaped curve for the risk of adverse birth outcomes with maternal hemoglobin concentrations, but the relations differ by trimester. For low hemoglobin concentrations, the link with adverse outcomes is more evident when hemoglobin concentrations are measured in early pregnancy. These relations generally became weaker or nonexistent when hemoglobin concentrations are measured in the second or third trimesters. Associations between high hemoglobin concentration and adverse birth outcomes are evident in all 3 trimesters but evidence is mixed. There is less evidence for the associations between maternal iron status and adverse birth outcomes. Most studies used serum ferritin (SF) concentrations as the indicator of iron status, which makes the interpretation of results challenging because SF concentrations increase in response to inflammation or infection. The effect of iron supplementation during pregnancy may depend on initial iron status. There are several mechanisms through which high iron status during pregnancy may have adverse effects on birth outcomes, including oxidative stress, increased blood viscosity, and impaired systemic response to inflammation and infection. Research is needed to understand the biological processes that underlie the U-shaped curves seen in observational studies. Reevaluation of cutoffs for hemoglobin concentrations and indicators of iron status during pregnancy is also needed.Am J Clin Nutr 2017;106(Suppl):1694S-702S.

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“…High Fe intakes (another commonly used mineral supplement), particularly if coupled with low dietary Cu intake, can also lower Cu status. Recent evidence shows that supplementation of Fe to pregnant women who have good Fe status can reduce serum Cu, increase the risk for hypertension in the mother, and increase the incidence of small‐for‐gestational age in the offspring, arguing against indiscriminate Fe supplementation during pregnancy [25, 26]. Fe supplements can also reduce indices of Cu status in breastfed infants [27] and increase morbidity [28].…”

Section: Secondary Cu Deficienciesmentioning

confidence: 99%

Influence of copper on early development: Prenatal and postnatal considerations

et al. 2010

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Copper (Cu) is an essential nutrient whose requirement is increased during pregnancy and lactation. These represent times of critical growth and development, and the fetus and neonate are particularly vulnerable to deficiencies of this nutrient. Genetic mutations that predispose the offspring to inadequate stores of Cu can be life threatening as is observed in children with Menkes disease. During the last decade, severe Cu deficiency, once thought to be a rare condition, has been reported in the literature at an increasing frequency. Secondary Cu deficiencies can be induced by a variety of ways such as excessive zinc or iron intake, certain drugs, and bariatric surgery. Premature and low birth weight infants can be born with low Cu stores. A number of mechanisms can contribute to the teratogenicity of Cu including decreased activity of select cuproenzymes, increased oxidative stress, decreased nitric oxide availability, altered iron metabolism, abnormal extracellular matrix protein crosslinking, decreased angiogenesis and altered cell signaling among others. The brain, heart, and vessels as well as tissues such as lung, skin and hair, and systems including the skeletal, immune, and blood systems, are negatively affected by suboptimal Cu during development. Additionally, persistent structural, biochemical, and functional adverse effects in the offspring are noted even when Cu supplementation is initiated after birth, supporting the concept that adequate Cu nutriture during pregnancy and lactation is critical for normal development. Although Cu-containing IUDs are an effective method for increasing intrauterine Cu concentrations and for reducing the risk of pregnancy, high amounts of dietary Cu are not thought to represent a direct developmental risk.

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The effects of iron supplementation on serum copper and zinc levels in pregnant women with high‐normal hemoglobin

Abstract: Iron supplementation in pregnant women with hemoglobin greater than 13.2 g/dL reduces serum levels of copper and zinc.

Cited by 37 publications

References 16 publications

Anaemia, Zinc and Copper Deficiencies Among Pregnant Women in Central Sudan

Anaemia, Zinc and Copper Deficiencies Among Pregnant Women in Central Sudan

U-shaped curve for risk associated with maternal hemoglobin, iron status, or iron supplementation

Influence of copper on early development: Prenatal and postnatal considerations

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