MATERNAL ERYTHROPOIETIN IN SINGLETON PREGNANCIES - A RANDOMIZED TRIALON THE EFFECT OF ORAL HEMATINIC SUPPLEMENTATION

OBJECTIVE: Our purpose was to study the effect of hematinic supplement ation on the maternal erythropoietin response during singleton pregnan cy. STUDY DESIGN: In a randomized, double-blind trial 97 patients with a first-trimester hemoglobin level greater-than-or-equal-to 14.0 gm/d l received either iron and folic acid (hematinic group, n = 53) or a p lacebo (n = 44). Serial hemoglobin, hematocrit, and serum erythropoiet in were recorded from maternal blood and from cord blood on delivery. Serum ferritin was measured in the first trimester, at 36 weeks' gesta tion, and in cord blood. RESULTS: In both groups (1) the mean hemoglob in was lower (p < 0.01) at 40 weeks' gestation than when first examine d and (2) the mean serum erythropoietin was higher (p < 0.01). The mea n serum ferritin was lower (p < 0.001) in both groups at 36 weeks' ges tation than at presentation but higher (p = 0.04) in the hematinic gro up than in the placebo group. The mean hemoglobin and hematocrit were similar in the two groups until the third trimester but thereafter wer e higher (p < 0.05) in the hematinic group. The mean maternal serum er ythropoietin was higher (p < 0.05) in the placebo group than in the he matinic group after 24 weeks' gestation. The mean cord blood hematolog ic values were similar in the two groups. CONCLUSION: Maternal serum e rythropoietin increased during pregnancy, but this response was reduce d in the third trimester in the hematinic-supplemented group.