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Open AccessArticle

The Effectiveness of Different Doses of Iron Supplementation and the Prenatal Determinants of Maternal Iron Status in Pregnant Spanish Women: ECLIPSES Study

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Department of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, 43201 Reus, Spain
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Tarragona–Reus Research Support Unit, Jordi Gol University Institute for Primary Care Research, 43202 Tarragona, Spain
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Clinical Laboratory, University Hospital Joan XXIII, Institut Català de la Salut, Generalitat de Catalunya, 43005 Tarragona, Spain
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Sexual and Reproductive Health Service of Reus–Tarragona, Institut Català de la Salut, Generalitat de Catalunya, 43202 Tarragona, Spain
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Meiji Pharma Spain S.A. (formerly Tedec-Meiji Farma S.A.) Alcalá de Henares, 28802 Madrid, Spain
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CIBERobn (Center for Biomedical Research in Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(10), 2418; https://doi.org/10.3390/nu11102418
Received: 16 September 2019 / Revised: 7 October 2019 / Accepted: 7 October 2019 / Published: 10 October 2019
(This article belongs to the Special Issue Nutrition for Anemia)
Iron deficiency (ID), anemia, iron deficiency anemia (IDA) and excess iron (hemoconcentration) harm maternal–fetal health. We evaluated the effectiveness of different doses of iron supplementation adjusted for the initial levels of hemoglobin (Hb) on maternal iron status and described some associated prenatal determinants. The ECLIPSES study included 791 women, randomized into two groups: Stratum 1 (Hb = 110–130g/L, received 40 or 80mg iron daily) and Stratum 2 (Hb > 130g/L, received 20 or 40mg iron daily). Clinical, biochemical, and genetic information was collected during pregnancy, as were lifestyle and sociodemographic characteristics. In Stratum 1, using 80 mg/d instead of 40 mg/d protected against ID on week 36. Only women with ID on week 12 benefited from the protection against anemia and IDA by increasing Hb levels. In Stratum 2, using 20 mg/d instead of 40 mg/d reduced the risk of hemoconcentration in women with initial serum ferritin (SF) ≥ 15 μg/L, while 40 mg/d improved SF levels on week 36 in women with ID in early pregnancy. Mutations in the HFE gene increased the risk of hemoconcentration. Iron supplementation should be adjusted to early pregnancy levels of Hb and iron stores. Mutations of the HFE gene should be evaluated in women with high Hb levels in early pregnancy. View Full-Text
Keywords: iron supplementation; pregnancy; randomized controlled trial; serum ferritin; hemoglobin; iron status; iron stores; HFE gene iron supplementation; pregnancy; randomized controlled trial; serum ferritin; hemoglobin; iron status; iron stores; HFE gene
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Iglesias Vázquez, L.; Arija, V.; Aranda, N.; Aparicio, E.; Serrat, N.; Fargas, F.; Ruiz, F.; Pallejà, M.; Coronel, P.; Gimeno, M.; Basora, J. The Effectiveness of Different Doses of Iron Supplementation and the Prenatal Determinants of Maternal Iron Status in Pregnant Spanish Women: ECLIPSES Study. Nutrients 2019, 11, 2418.

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