The determinants of iron status in early pregnancy

Abstract

In pregnancy, the additional demands for Fe are thought to be met principally through increased maternal dietary Fe absorption and by mobilization of maternal Fe stores. In a general population sample of 576 women we examined the maternal and dietary characteristics which influenced Fe stores (assessed by serum ferritin concentration) in early pregnancy. The effects of these characteristics on two measures of functional Fe status (mean cell volume and haemoglobin concentration) were also considered. Serum ferritin concentrations were lower in multiparous women (P < 0.0001) and in those with a lower BMI (P = 0.01), and rose with increasing alcohol intake (P < 0.0001). Ferritin concentrations fell with increasing Ca intake (P < 0.0001); the proportion of women with serum ferritin values ≤ 12 μg/l rose from 14% of the women in the lowest quarter of Ca intake to 29% of the women in the highest quarter. Mean cell volume and haemoglobin concentration were not related to Ca intake in early pregnancy. Although Ca added to test-meals reduces Fe absorption, long-term Ca supplementation has not been shown to lower plasma ferritin concentration, suggesting that high habitual Ca intakes would be unlikely to influence Fe status in non-pregnant individuals. Our findings show that in early pregnancy there is an association between high dietary Ca intake and lower Fe stores. This effect of Ca on one aspect of Fe status may result from its influence on Fe bioavailability.