Arthur Amit Suryakumar, (2022) Hepcidin and Iron-Related Parameters in Pregnancy: How Do they Correlate? Masters thesis, Christian Medical College, Vellore.
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Abstract
BACKGROUND: In pregnancy, there is an increased requirement for iron to meet maternal and fetal demands. How exactly the placenta takes up iron from the maternal blood and transfers it to the fetus is not clear. Hepcidin is the central regulator of systemic iron homeostasis. Its levels in maternal blood have been shown to decrease in pregnancy to enable uptake of iron by the fetus. The underlying mechanism for such decreases is not known. It is also not clear to what extent maternal iron status during pregnancy influences that of the fetus. AIM OF THE STUDY: The aim of this study is to study haematological and iron-related parameters, and a marker of inflammation, in blood from pregnant women and in the cord blood of their babies, and to determine how these parameters correlate with each other and with outcomes of pregnancy. OBJECTIVES: 1. To estimate iron-related and haematological parameters, and a marker of inflammation, in blood from pregnant women and in the cord blood of their babies. 2. To determine how these parameters correlate with each other and with outcomes of pregnancy. METHODOLOGY: Primigravidae, with uncomplicated pregnancies, who attended the antenatal clinics of Unit 4 of the Department of Obstetrics and Gynaecology, at Christian Medical College (CMC), Vellore, India, were the subjects of the study. They were recruited in their first trimester, after obtaining informed consent. Blood samples were collected from them. At the time of delivery, a sample of cord blood was also obtained. Haematological parameters (haemoglobin and mean corpuscular volume) and parameters linked to iron were estimated in the blood samples collected. The latter consisted of concentration of serum ferritin, serum iron and total iron-binding capacity (TIBC). Transferrin saturation was calculated from values of serum iron and TIBC. Concentrations of serum C-reactive protein (a marker of systemic inflammation) were also estimated. Correlations were determined between maternal and fetal parameters studied. RESULTS: Twenty subjects were recruited for the study. Their mean age was 25 years (SD 3.21), gestational age at delivery was 39.6 weeks (SD 0.98), hemoglobin level was 12.01 gm/dL (SD 1.14) and MCV was 82.27 fL (SD 1.14). Mean maternal serum iron was 74 μg/dL (SD 29.30), ferritin was 29.72 ng/mL (SD 30.48), TIBC was 383.3 μg/dL (SD 51.90) and transferrin saturation was 20.19% (SD 9.03). The mean weight of the babies delivered was 3.07 kg (SD 0.31). In cord blood, the mean hemoglobin value was 14.92 g/dL (SD 2.16) and MCV was 111.2 fL (SD 4.59). Mean serum iron was 114.19 μg/dL (SD 24.54), serum ferritin was 131.73 ng/dL (SD 53.89), TIBC was 273.42 μg/dL (SD 50.69) and transferrin saturation was 42.51% (SD 8.92). In the maternal samples, serum iron correlated significantly and positively with serum ferritin and transferrin saturation, and negatively with TIBC. Maternal serum hepcidin correlated significantly and positively with maternal serum iron and transferrin saturation. Iron-related parameters in cord blood also correlated with one another and with some hematological parameters. Maternal total iron binding capacity (TIBC) correlated significantly and positively with cord blood haemoglobin. Maternal mean corpuscular volume (MCV) correlated significantly and positively with cord blood mean corpuscular volume (MCV). CONCLUSION: Maternal serum hepcidin in the first trimester correlated significantly and positively with maternal serum iron and transferrin saturation. Work is ongoing to determine if this is so in the other 2 trimesters as well, and also in cord blood.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201923201 |
| Uncontrolled Keywords: | Hepcidin, Iron-Related Parameters, Pregnancy. |
| Subjects: | MEDICAL > Biochemistry > MEDICAL > Biochemistry |
| Depositing User: | Subramani R |
| Date Deposited: | 17 May 2021 17:13 |
| Last Modified: | 03 Mar 2024 05:08 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/17000 |
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