Iron homeostasis and oxidative status features among pregnant women with anemia of various genesis

• Bakhtykei M. Gasanova
• Miroslava L. Polina

Abstract

Aim of the study - to evaluate iron metabolism and ferrokinetics features among pregnant women with iron deficiency anemia (IDA) and anemia of chronic diseases (ACD).

Material and methods. 120 pregnant women with IDA, 68 - with ACD, 34 healthy pregnant women were examined within the study.

Research methods: general blood test, proteins of the acute phase of inflammation [C-reactive protein (CRP), ferritin), total protein, transferrin, serum iron, serum cytokines [interleukin-1β (IL-1β), tumor necrosis factor-а (TNF-α), interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-8 (IL-8), interferon-γ (INF-γ)], antioxidant protection factors (catalase of blood plasma and red blood cells, sulfhydryl groups, ceruloplasmin) and oxidative stress (malondialdehyde, MDA).

Results. Pregnant women with anemia and high infectious risk are distinguished by adaptive reaction of iron redistribution to chronic inflammation (acute phase proteins of inflammation - CRP, ferritin).

Iron homeostasis features among pregnant women with IDA include erythroid growth depletion on the background of moderate cytokine production (interleukins - IL-1β, IL-4, IL-8, IL-10 and TNF-α, INF-γ) and the balance of peroxidation reactions.

The severity of oxidative stress (increased MDA) in IDA was balanced by the increase in antioxidant protection factors (plasma catalase and red blood cells, sulfhydryl groups). The increase in CRP and ferritin during ACD was accompanied by activation of pro-inflammatory cytokines group, with a violation of erythropoiesis on the background of deposited iron. Pregnant women with ACD were distinguished by the development of placental insufficiency in 100%, greater perinatal morbidity compared to IDA.

Conclusions. Antenatal and perinatal dysfunction with ID was caused by the failure of adaptive homeostatic reactions, providing the functional safety of the feto-placental complex.

Keywords:iron deficiency anemia (IDA), anemia of chronic diseases (ACD), perinatal outcomes, oxidative stress, high infectious risk

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