Iron Absorption and Transfer to the Fetus During Pregnancy in Normal Weight and Overweight/Obese Women and the Effects on Infants Iron Status

NCT ID: NCT02747316

Last Updated: 2021-04-23

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 83 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-02-29
• Study Completion Date: 2020-09-30

Brief Summary

Overweight and obesity causes low-grade systemic inflammation, which sharply increases risk for iron deficiency. Studies in our laboratory have shown that this is mainly the result of reduced dietary iron absorption because of increased hepcidin concentrations. During pregnancy, women have a large increase in iron needs because of the expansion of maternal blood volume and fetal needs. Iron deficiency anemia in infancy can impair cognitive development. Whether maternal adiposity impairs absorption and transfer of iron to the fetus, and thereby increases risk of iron deficiency in the mother and the infant is unclear.

Detailed Description

In obese subjects, hepcidin concentrations are increased and iron absorption is believed to be reduced, leading to iron deficiency over time. How all this will influence iron supply of the fetus in obese pregnancy has not been well investigated to date. Even if maternal and fetal iron uptakes are regulated separately, it is unclear to what extent maternal subclinical inflammation might influence this process. A small study by Dao et al. indicated that maternal-fetal iron transfer was impaired in obese pregnant women, possibly due to hepcidin up-regulation. In this study, both maternal BMI as well as hepcidin were negatively correlated with cord blood iron status. Maternal hepcidin and c-reactive protein were significantly higher and cord blood iron was significantly lower in the obese compared to the normal weight. Hepcidin was shown to have an effect on iron transfer across the placenta in the study by Young et al.: the transfer was increased in women with undetectable hepcidin at delivery compared to those with higher levels. As of now, clear associations between maternal BMI or maternal hepcidin concentration and fetal iron status were not shown.

Conditions

Overweight; Obesity; Pregnancy

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: BASIC_SCIENCE
• Blinding Strategy: NONE

Study Groups

Isotopically labeled test meal week of pregnancy 20

Group Type: EXPERIMENTAL

Stable iron isotope 57 (57Fe) labeled iron solution

Intervention Type: OTHER

test meal labeled with 12 mg 57Fe

Isotopically labeled test meal week of pregnancy 30

Group Type: EXPERIMENTAL

Stable iron isotope 58 (58Fe) labeled iron solution

Intervention Type: OTHER

test meal labeled with 12 mg 58Fe

Interventions

Stable iron isotope 57 (57Fe) labeled iron solution

test meal labeled with 12 mg 57Fe

Intervention Type: OTHER

Stable iron isotope 58 (58Fe) labeled iron solution

test meal labeled with 12 mg 58Fe

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Pregnant women with either normal pre-pregnancy BMI (BMI 18.5 - 24.9kg/kg2) or with overweight or obesity (BMI > 27.5kg/m2) before pregnancy (assessed based on data reported by the women at their first visit at the hospital)
• 18 to 45 years old
• singleton pregnancy
• week of pregnancy 14±3

Exclusion Criteria

• underlying malabsorption disease
• chronic illness, which influences iron absorption
• inflammatory status other than obesity
• medical problems known to affect iron homeostasis
• smoking during pregnancy
• no regular use of medication, which influences iron absorption

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Swiss Federal Institute of Technology

OTHER

Sponsor Role: lead

Responsible Party

Isabelle Herter-Aeberli

Dr.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Human Nutrition Laboratory ETH Zurich

Zurich, , Switzerland

Countries

Switzerland

References

Stoffel NU, Zimmermann MB, Cepeda-Lopez AC, Cervantes-Gracia K, Llanas-Cornejo D, Zeder C, Tuntipopipat S, Moungmaithong S, Densupsoontorn N, Quack Loetscher K, Gowachirapant S, Herter-Aeberli I. Maternal iron kinetics and maternal-fetal iron transfer in normal-weight and overweight pregnancy. Am J Clin Nutr. 2022 Apr 1;115(4):1166-1179. doi: 10.1093/ajcn/nqab406.

Reference Type: DERIVED

PMID: 34910118 (View on PubMed)

Other Identifiers

PIANO

Identifier Type: -

Identifier Source: org_study_id