SERUM ERYTHROPOIETIN DURING NORMAL-PREGNANCY - RELATIONSHIP TO HEMOGLOBIN AND IRON STATUS MARKERS AND IMPACT OF IRON SUPPLEMENTATION IN A LONGITUDINAL, PLACEBO-CONTROLLED STUDY ON 118 WOMEN
N. Milman et al., SERUM ERYTHROPOIETIN DURING NORMAL-PREGNANCY - RELATIONSHIP TO HEMOGLOBIN AND IRON STATUS MARKERS AND IMPACT OF IRON SUPPLEMENTATION IN A LONGITUDINAL, PLACEBO-CONTROLLED STUDY ON 118 WOMEN, International journal of hematology, 66(2), 1997, pp. 159-168
Serum erythropoietin (EPO) and its relationship to hemoglobin (Hb), ir
on status markers and iron supplementation during normal pregnancy was
assessed in a longitudinal, placebo-controlled study on 118 women, 61
took daily tablets containing 66 mg ferrous iron from the second trim
ester until delivery and 57 took placebo. Blood samples were obtained
at 4-week intervals until delivery as well as post-partum. In the plac
ebo-treated women, median serum EPO rose from 22.5 U/l at inclusion to
35.0 U/l at delivery (P = 0.0001). In the iron-treated women, median
serum EPO rose from 23.9 to 29.9 U/l (P = 0.0001). Serum EPO showed a
steeper increase in the placebo-treated women than in the iron-treated
women (P < 0.05). After delivery, serum EPO became normal in both gro
ups (P = 0.0001). Median Hb was lower in placebo-treated (iron deplete
d) than in iron-treated (iron repleted) women (P < 0.05). In the place
bo-treated women there was a negative correlation and in the iron-trea
ted women a positive correlation between serum EPO and Hb. In the plac
ebo-treated women, inverse correlations existed between serum EPO and
serum transferrin saturation and serum ferritin, reflecting the conseq
uences of iron deficiency, whereas the iron-treated women displayed no
correlation. A physiological, nonhypoxia-induced increase in EPO prod
uction accounts for the basic expansion of the red cell mass during pr
egnancy. In placebo-treated women, iron deficient erythropoiesis const
itutes an additional hypoxic stimulus, which induces a further increas
e in serum EPO. (C) 1997 Elsevier Science Ireland Ltd.