Effect of iron and folate supplementation on Pb levels in pregnant anemic women: a prospective study.

There are few reports revealing association between iron intake and environmental lead exposure during pregnancy. Therefore, the present study was undertaken to investigate the effect of iron supplementation on biochemical modulation of certain lead toxicity markers associated with pregnancy. Iron and folic acid supplementations were given to 250 pregnant anemic women (mild = 100, moderate = 100 and severe = 50) and 100 age matched nonanemic pregnant women as controls for 100 days. Lead (Pb) toxicity markers, enzymatic and nonenzymatic antioxidant were estimated as per standard protocols. The levels of Pb, serum transferrin receptors (sTfR), zinc protoporphyrin (ZPP), δ-aminolevulinic acid (δ-ALA, both in blood and urine) were found significantly increased in all pretreated subjects and these were decreased after oral iron supplementation. Iron-deficient pregnant women reflected a significant increase in lipid peroxide levels (LPO) and protein carbonyl levels (PC) which were found to be further increased after iron supplementation. The levels of iron (Fe), haemoglobin (Hb), ferritin, delta aminolevulinic acid dehydratase (δ-ALAD), catalase (CAT), superoxide dismutase (SOD), and reduced glutathione levels (GSH) were significantly decreased in pretreated groups and these parameters were found significantly increased in all supplemented subjects after treatment. Antioxidant vitamins viz. C and E were found significantly decreased in all post treated groups. Our observation suggests that recommended iron dose is not only effective for blood indices parameters, but it also decreases Pb concentrations in the blood during pregnancy. However, further studies with larger sample size are needed to confirm these findings.

Study on Impact of Iron and Folic Acid on the Plasma Trace Minerals in Pregnant Anemic Women.

Iron deficiency anemia is one of the causes that lead to significant mortality and morbidity among pregnant women and fetus. The present study was undertaken to explore oral iron supplementation can modify the metal contents in pregnant anemic women. Iron and folic acid supplementations was given to 500 anemic women (mild = 200, moderate = 200, and severe = 100) and 100 age matched non-anemic controls daily for 100 days. Blood index values and plasma trace minerals were estimated as per standard protocols. Haemoglobin and ferritin levels were found significantly increased (p < 0.001) in anemic and control subjects after treatment. Moreover, the serum transferring receptor levels and total iron binding capacity were found significantly decreased in all treated groups. Iron (Fe), zinc (Zn) and copper (Cu) levels were found increased (p < 0.01) after oral iron supplementation groups. Moreover, selenium (Se) manganese (Mn) and were found to be decreased in all treated groups. Data provides the conclusion that iron and folic acid supplementation recovered the essential trace minerals, except manganese, which may lead to various complications including peroxidation of vital body molecules resulting in increased risk for pregnant women as well as fetus.

Evaluation of Low Blood Lead Levels and Its Association with Oxidative Stress in Pregnant Anemic Women: A Comparative Prospective Study.

To correlate blood lead levels (BLLs) and oxidative stress parameters in pregnant anemic women. A total of 175 pregnant women were found suitable and included for this study. Following WHO criteria, 50 each were identified as non-anemic, mild anemic and moderate anemic and 25 were severe anemic. The age of all study subjects ranged from 24-41 years. At admission, BLLs and oxidative stress parameters were estimated as per standard protocols and subjected with ANOVA, Pearson correlation analysis and cluster analysis. Results showed significantly (p < 0.01) high BLLs, zinc protoporphyrin (ZPP), oxidized glutathione (GSSG), lipid peroxide (LPO) levels while low delta aminolevulinic acid dehydratase (δ-ALAD), iron (Fe), selenium (Se), zinc (Zn), haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), red blood cell (RBC) count, reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) and total antioxidant capacity (TAC) in all groups of anemic pregnant women as compared with non anemic pregnant women. In all groups of pregnant women, BLLs showed significant (p < 0.01) and direct association with ZPP, GSSG and LPO while inverse relation with δ-ALAD, Fe, Se, Zn, Hb, Hct, MCV, MCH, MCHC, RBC, GSH, SOD, CAT and TAC. Study concluded that low BLLs perturb oxidant-antioxidant balance and negatively affected hematological parameters which may eventually Pb to Fe deficiency anemia during pregnancy.

Oral iron supplementation leads to oxidative imbalance in anemic women: a prospective study.

BACKGROUND & AIMS: This study was aimed to assess the desirable and undesirable effects of iron (100 mg/day as ferrous sulphate) and folic acid (500 µg/day) supplementation in iron deficient anemic women. METHODS: Iron and folic acid supplementations were given to 117 anemic women (mild = 55, moderate = 40, and severe = 22) and 60 age matched placebo treated (100 mg cane sugar) non-anemic controls for 100 days. Blood index values, oxidative stress parameters, antioxidant enzymes and vitamins were estimated as per standard protocols. RESULTS: Haemoglobin (Hb) levels along with antioxidant enzymes, namely catalase, superoxide dismutase (SOD), glutathione reductase (GSH-Rd), reduced glutathione (GSH) and total antioxidant capacity (TAC) were found significantly increased (P < 0.01) in anemic women after treatment. However, the glutathione peroxidase (GSH-Px) and antioxidant vitamins A, C and E were found significantly decreased (P < 0.01) in all treated groups. Lipid peroxide levels (LPO), protein carbonyl (PC), conjugated dienes (CD), lipid hydroperoxide (LOOH) and oxidized glutathione (GSSG) levels were found significantly increased (P < 0.01) after oral iron supplementation groups. Moreover, undesirable side effects of iron supplementation were observed maximally in mild as compared with moderate and severe anemic groups, whereas nausea, vomiting, systemic reactions were negligible in all treated subjects. CONCLUSION: Study found recommended dose of iron effective for improving Hb, but at the cost of increased oxidative stress (mild > moderate > severe). It is suggested that blind iron supplementation should be avoided and shall be provided on need basis.

Evaluation of oxidative stress and antioxidant status in pregnant anemic women.

The present study was conducted to investigate the oxidant-antioxidant status in iron deficient pregnant anemic women. One hundred thirty pregnant women with iron deficiency anemia (IDA) were divided into three groups, namely mild (50), moderate (50) and severe (30) anemic along with pregnant healthy women as controls (50). The complete blood count, plasma lipid peroxidation products, enzymatic and non-enzymatic antioxidants were measured according to respective protocols. The levels of complete blood count, iron, ferritin along with antioxidant enzymes namely catalase, superoxide dismutase, glutathione peroxidase, glutathione reductase and reduced glutathione were significantly reduced in all IDA groups. However, the level of oxidized glutathione, lipid peroxides, protein carbonyls, conjugated dienes were found significantly increased in all anemic patients. Antioxidant vitamins, namely C, E and A were also found significantly decreased in IDA patients. On the basis of our results, it may be concluded that IDA tends to increase the pro-oxidant components, which may result in various complications including peroxidation of vital body molecules resulting in increased risk for pregnant women as well as fetus.