Miscarriage and Oxidative Stress of Iron Supplementation during Pregnancy

Abstract

Background: Iron supplementations to the pregnant women in Iraq mostly considered as obligatory routine health care additive treatment without real assessing to the iron status in these people, therefore the acceptable range of iron must be estimated and the relationship between iron status and miscarriage should be explored. Objective: In miscarriage and pregnant women that supplemented with iron tablets the levels of oxidative stress should be assessed and compared to the iron status to show the type and the strength of correlation between them. Patients and methods: 96 pregnant women were participate in this study and categorized into. First group: Pregnant iron supplemented group (PIS group) includes 35 pregnant women (36.46%) during their 1st trimester or middle of 2nd trimester of pregnancy (18-36 year) and they were received an oral iron supplementation as 250 mg of ferrous gluconate tablet, three times a day. Second group: Pregnant iron non- supplemented group (PINS group) includes 31 pregnant women (32.29%) during their 1st trimester or middle of 2nd trimester of pregnancy (19-37 year) and they were non supplemented with iron and they considered as control group. Third group: Miscarriage iron supplemented group (MIS group) includes 30 miscarriage pregnant women(31.3%) during their 1st trimester or middle of 2nd trimester (19-40 year) taken an oral iron supplementation as 250 mg of ferrous gluconate tablet, three times a day. Results: The study at first assess the iron status by measuring Hb, serum ferritin and serum iron in the three groups of women and shows that there is a significant differences p< 0.005 between oxidative stress parameters of the miscarriage women and the pregnant women that taken oral supplements of iron tablets. The MDA and PC were higher in miscarriage in comparison to pregnant. The decrement in GSH level in miscarriage was also significant (P value< 0.025). The correlations between serum iron concentration and oxidative stress parameters MDA, PC and GSH were plotted using the regression line analysis where the r2 values were obtained respectively r2 = 0.63, r2 = 0.55 and r2 = 0.70. It is obvious that there is a high correlation between the level of iron in the circulation and the oxidative stress of the reactive oxygen species that generated by the catalytic effect of this transition metal. Conclusion: The high level of iron that obligatory supplemented to the pregnant women in Iraq should be restricted and early careful investigation should be performed to assess the status of iron before any iron supplements prescribed. The spontaneous abortion or miscarriage is highly correlated to the oxidative stress that induced by the flood of iron in the circulation.