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Erythropoiesis and Red Cell Indices Undergo Adjustments during Pregnancy in Response to Maternal Body Size but not Inflammation

1
Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México CP. 11000, Mexico
2
Departamento de Ciencias de la Salud, Universidad del Valle de México, Coyoacán, Ciudad de México CP. 04910, Mexico
3
Departamento de Salud, Universidad Iberoamericana, Lomas de Santa Fe, Ciudad de México CP. 01219, Mexico
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(4), 975; https://doi.org/10.3390/nu12040975
Received: 19 February 2020 / Revised: 24 March 2020 / Accepted: 26 March 2020 / Published: 1 April 2020
During human pregnancy, iron requirements gradually increase, leading to higher amounts of erythropoietin (EPO) and reticulocytes, and changes in erythrocyte size and density. Women with pregestational obesity experience “obesity hypoferremia” during pregnancy, which alters iron homeostasis. In this study we aimed to describe the relationship between EPO and iron nutrition status during nonanemic pregnancy, and to explore whether obesity and inflammation influence erythropoiesis and red cell indices. We conducted a secondary analysis of a cohort followed throughout pregnancy. Participants were nonanemic women assigned to two study groups based on pregestational body mass index (pgBMI): adequate weight (AW, n = 53) or obesity (Ob, n = 40). All received a multivitamin supplement. At gestational ages (GA) 13, 21, 28 and 34, we measured hemoglobin and red cell indices with an ACT-5DIFF hematology counter, and reticulocyte percentage by manual cell counting. EPO, interleukin (IL–6) and markers of iron status, i.e., hepcidin, serum transferrin receptor (sTfr) and ferritin, were measured by ELISA. Bivariate correlations showed that EPO was positively associated with pgBMI, GA, sTfr and IL-6, but negatively associated with hepcidin, ferritin and hemoglobin, and unrelated to iron intake. Generalized linear models adjusted for confounding factors showed that EPO and erythrocyte concentrations were significantly higher in women in the Ob group, while mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and red cell distribution width (RDW) were lower; reticulocytes and mean corpuscular hemoglobin concentration (MCHC) were not different. Differences were not altered when controlling for inflammation (IL–6). These changes suggest that, in addition to altering iron metabolism, a larger maternal body size during pregnancy results in higher erythropoiesis without increasing hemoglobin, which is exhibited in the latter being distributed among more and smaller erythrocytes. View Full-Text
Keywords: erythropoietin; red cell indices; pregnancy; maternal obesity; inflammation; hepcidin; hemoglobin erythropoietin; red cell indices; pregnancy; maternal obesity; inflammation; hepcidin; hemoglobin
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MDPI and ACS Style

Vega-Sánchez, R.; Tolentino-Dolores, M.C.; Cerezo-Rodríguez, B.; Chehaibar-Besil, G.; Flores-Quijano, M.E. Erythropoiesis and Red Cell Indices Undergo Adjustments during Pregnancy in Response to Maternal Body Size but not Inflammation. Nutrients 2020, 12, 975. https://doi.org/10.3390/nu12040975

AMA Style

Vega-Sánchez R, Tolentino-Dolores MC, Cerezo-Rodríguez B, Chehaibar-Besil G, Flores-Quijano ME. Erythropoiesis and Red Cell Indices Undergo Adjustments during Pregnancy in Response to Maternal Body Size but not Inflammation. Nutrients. 2020; 12(4):975. https://doi.org/10.3390/nu12040975

Chicago/Turabian Style

Vega-Sánchez, Rodrigo, Mari C. Tolentino-Dolores, Blanca Cerezo-Rodríguez, Georgette Chehaibar-Besil, and María E. Flores-Quijano 2020. "Erythropoiesis and Red Cell Indices Undergo Adjustments during Pregnancy in Response to Maternal Body Size but not Inflammation" Nutrients 12, no. 4: 975. https://doi.org/10.3390/nu12040975

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