Antenatal iron supplementation and serum non-transferrin bound iron in Kenyan women: a randomized placebo-controlled trial
Year: 2015
Type: book
Abstract: Introduction: Supplementation with ferrous iron can lead to increasedrates of malaria, possibly through the transient production ofnon-transferrin bound iron (NTBI). Evidence that iron supplementationcan lead to NTBI production is mostly derived from small, mostlynon-randomized studies using volunteers with adequate iron statusand without infections or inflammation, and using NTBI quantitationmethods with inherent limitations. Little is known about factors thatinfluence the magnitude of the serum NTBI response to iron ingestion.Objectives: We measured the effect of ingestion of a single ironsupplement on serum NTBI concentrations in pregnant Kenyan women.We also explored the influence of initial iron status, gravidity,maternal age, Plasmodium infection, HIV infection, α+-thalassemiagenotype on the NTBI response.Method / Design: Rural Kenyan women with singleton pregnancies,gestational age 13─23 weeks and hemoglobin concentration≥90g/L were randomized to supplementation with iron (60mg asferrous fumarate) versus placebo. Approximately 1.5h after ingestingthe first supplement, participants were offered an optional nonstandardizedlunch meal. Blood was collected at baseline and after3hours. Serum NTBI concentrations were determined using a novel,flow cytometry-based assay.Results: 379 women participated. Compliance was 100%. NTBIconcentrations after 3 hours were similar between groups (mean forboth: 0.18 μmol/L; difference, 95%CI: 0.01μmol/L, –0.03μmol/L to0.05μmol/L). NTBI was present in 40.9% and 46.1% of women in ironversus placebo groups (difference: 5.3%, –15.0% to 4.7%). We foundno evidence of effect modification by any of the baseline factors investigated.Conclusions: There was no evidence that oral iron supplementationled to NTBI production when the supplement was given withfood to women in their second trimester of pregnancy. These resultscannot be extrapolated to pregnant women who ingest supplementswithout food, or to those in their third trimester of pregnancy
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2790165866