THE RESPONSE TO IRON SUPPLEMENTATION OF PREGNANT-WOMEN WITH THE HEMOGLOBIN GENOTYPE AA OR AS

The influence of haemoglobin genotype on the response to iron suppleme ntation was studied in a randomized, double blind, placebo-controlled trial involving 497 multigravid pregnant women from a rural area of Th e Gambia. Women were randomly allocated to receive either oral iron (6 0mg elemental iron per day) or placebo. At 36 weeks of pregnancy, wome n who had received oral iron during pregnancy had higher mean haemoglo bin, packed cell volume, plasma iron and ferritin levels than did wome n who received placebo. Iron supplementation of pregnant women with th e AA haemoglobin genotype also resulted in increases in the packed cel l volume (PCV) and haemoglobin level measured after delivery, and in t he birth weight of the infant. However, in AS women PCV and haemoglobi n level at delivery were lower in the supplemented group and supplemen tation was also associated with reduced birth weights. In malaria ende mic areas, pregnant women with the haemoglobin genotype AS may not ben efit from iron supplementation during pregnancy.