Abstract
Iron Deficiency anemia ranks 9th among 26 diseases with highest burden. Asia bears 71% of this global burden. Adverse maternal and birth outcome associated with hemoglobin status renders the issue worth attention. Indian scenario has worsened over the period despite continuous international and national efforts. This indicates some lacunae in the approach and strategies applied. Various reports state that even with maximum effort to increase outreach and monitoring for adherence to Iron schedule, consumer’s compliance remains abysmally low. Recent studies has pointed out biological basis of side effects (gastrointestinal complains and systemic events) as raised oxidative stress for which iron is the key catalyst. Up till now the only target of research has been to raise hemoglobin of pregnant women above 11gm/dl. With the reports of pregnancy specific morbidities i.e. hemorrhage and septicemia with low hemoglobin, eclampsia, small for gestation age, gestational diabetes with higher ranges of hemoglobin, alarm is raised to define optimum range. Use of oxidative stress as biochemical marker with different doses and schedules has been defined because India lack information for its own population upon oxidative stress status when iron is supplemented as per current guidelines. Studies done in India and abroad have defined that too much and too less, both may raise oxidative stress and studies of this sort may provide biochemical scale for optimization. This review therefore has evaluated currently available Indian research and reports to understand the need of future research area. Important findings from other countries have been incorporated for comparison.
Key Words: Oxidative stress, Iron supplementation, Anemia during pregnancy
Full Text
The Full Text of this article is available as a PDF (156.5 KB).
References
- 1.Sloan N.L., Jordan E., Winikoff B. Effects of Iron Supplementation on Maternal Hematologic Status in Pregnancy. Am J Public Health. 2002;92(2):288–293. doi: 10.2105/AJPH.92.2.288. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Rehema A., Zilmer K., Klaar U., Karro H., Kullisaar T., Zilmer M. Ferrous iron administration during pregnancy and adaptational oxidative stress (Pilot study) Medicina (kaunas) 2004;40(6):547–552. [PubMed] [Google Scholar]
- 3.Kumar A. National nutritional anaemia control programme in India. Ind J Public Health. 1999;43(1):3–5. [PubMed] [Google Scholar]
- 4.Makrides M., Crowther C.A., Gibson R.A., Gibson R.S., Skeaff C.M. Efficacy and tolerability of low dose iron supplements during pregnancy: a randomized controlled trial. Am J Clin Nutr. 2003;78(1):145–153. doi: 10.1093/ajcn/78.1.145. [DOI] [PubMed] [Google Scholar]
- 5.Galleano M., Puntarulo S. Effect of mild iron overload on liver and kidney lipid peroxidation. Braz J Med Biol Res. 1994;27(10):2349–2358. [PubMed] [Google Scholar]
- 6.Zwart L.L., Meerman J.N., Commandeur J.N.M., Vermeulen N.P.E. Biomarkers of free radical damage. Applications in experimental animals and humans. Free Radic Biol Med. 1999;26:202–226. doi: 10.1016/S0891-5849(98)00196-8. [DOI] [PubMed] [Google Scholar]
- 7.Walter P.B., Knutson M.D., Martinez A.P., Lee S., Xu Y., Viteri F.E., Ames B.N. Iron deficiency and iron excess damage mitochondria and mitochondrial DNA in rats. Proc Natl Acad Sci. 2002;99:2264–2269. doi: 10.1073/pnas.261708798. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Lachili B., Hininger I., Faure H., Arnaud J., Richard M.J., Favier A., et al. Increased lipid peroxidation in pregnant women after iron and vitamin C supplementation. Biol Trace Elem Res. 2001;83(2):103–110. doi: 10.1385/BTER:83:2:103. [DOI] [PubMed] [Google Scholar]
- 9.Kurtoglu E., Ugur A., Baltaci A.K., Undar L. Effect of iron supplementation on oxidative stress and antioxidant status in iron deficiency anemia. Biol Trace Elem Res. 2003;96(1–3):117–123. doi: 10.1385/BTER:96:1-3:117. [DOI] [PubMed] [Google Scholar]
- 10.Scanlon K.S., Yip R., Schieve L.A., Cogswell M.E. High and low hemoglobin levels during pregnancy: differential risks for preterm birth and small for gestational age. Obstet Gynecol. 2000;96(5Pt1):741–748. doi: 10.1016/S0029-7844(00)00982-0. [DOI] [PubMed] [Google Scholar]
- 11.Wisdom S.J., Wilson R., McKillop J.H., Walker J.J. Antioxidant systems in normal pregnancy and in pregnancy-induced hypertension. Am J Obstet Gynecol. 1991;165:170–174. doi: 10.1016/0002-9378(91)90018-m. [DOI] [PubMed] [Google Scholar]
- 12.Anand A. Anemia- a major cause of maternal death. Ind Med Trib. 1995;3(1):5–8. [PubMed] [Google Scholar]
- 13.NNMB Technical report No. 24. National nutrition Monitoring Bureau-Diet and Nutrition status of population and prevalence of hypertension among adults in rural areas. NIN, ICMR, 2006.
- 14.Bedi N., Kambo I., Dhillon B.S., Saxena B.N., Singh P. Maternal deaths in India - Preventable tragedies (An ICMR Task force Study) J Obst Gyn of Ind. 2001;51(2):86–92. [Google Scholar]
- 15.Stoltzfus R.J. Iron deficiency: global prevalence and consequences. Food Nutr Bull. 2003;24(4Suppl):S99–S103. doi: 10.1177/15648265030244S206. [DOI] [PubMed] [Google Scholar]
- 16.National Family Health Survey - 3. Mumbai: International Institute of Population Sciences; 2007. [Google Scholar]
- 17.NNMB Technical Report No. 22. National Nutrition Monitoring Bureau. Prevalence of Micronutrient Deficiencies. National Institute of Nutrition. Indian Council of Medical Research. Hyderabad — 500 007, 2003.
- 18.Awasthi S, Pande VK. Prevalence of malnutrition and intestinal parasites in preschool slum children in lucknow. Ind Pead 1997; 34. [PubMed]
- 19.Community-Level Interventions to Prevent and Treat Anemia: A Review of Evidence from India March 2008, Evidence review series-3, USAIDS- Vistaar Project link: www.intrahealth.org
- 20.Vijayaraghavan K., Brahmam G.N.V., Nair K.M., Akbar D., Rao N.P. Evaluation of national nutritional anemia prophylaxis programme. Ind J Pead. 1990;7(2):183–190. doi: 10.1007/BF02722084. [DOI] [PubMed] [Google Scholar]
- 21.Sharma J.B., Jain S., Mallika V., Singh T., Kumar A., Arora R., et al. A prospective, partially randomized study of pregnancy outcomes and hematologic responses to oral and intramuscular iron treatment in moderately anemic pregnant women. Am J Clin Nutr. 2004;79(1):116–122. doi: 10.1093/ajcn/79.1.116. [DOI] [PubMed] [Google Scholar]
- 22.Nair K.M., Bhaskaram N., Balakrishna P., Sesikeran R.B. Response of hemoglobin, serum ferritin, and serum transferrin receptor during iron supplementation in pregnancy: a prospective study. Nutrition. 2004;20(10):896–899. doi: 10.1016/j.nut.2004.06.011. [DOI] [PubMed] [Google Scholar]
- 23.Gomber S., Agarwal K.N., Mahajan C., Agarwal N. Impact of daily versus weekly hematinic supplementation on anemia in pregnant women. Ind Pediatr. 2002;39(4):339–346. [PubMed] [Google Scholar]
- 24.Malhotra M., Sharma J.B., Batra S., Sharma S., Murthy N.S., Arora R. Maternal and perinatal outcome in varying degrees of anemia. Int J Gynaecol Obs. 2002;79(2):93–100. doi: 10.1016/S0020-7292(02)00225-4. [DOI] [PubMed] [Google Scholar]
- 25.Brabin B.J., Hakimi M., Pelletier D. An analysis of anemia and pregnancy-related maternal mortality. J Nutr. 2001;131(2S–2):604S–614S. doi: 10.1093/jn/131.2.604S. [DOI] [PubMed] [Google Scholar]
- 26.Scanlon K.S., Yip R., Schieve L.A., Cogswell M.E. High and Low Hemoglobin Levels During Pregnancy: Differential Risks for Preterm Birth and Small for Gestational Age. Obs & Gynecol. 2000;96:741–748. doi: 10.1016/S0029-7844(00)00982-0. [DOI] [PubMed] [Google Scholar]
- 27.Lieberman E., Ryan K.J., Monson R.R., Schoenbaum S.C. Association of maternal hematocrit with premature labor. Am J Obs Gynecol. 1988;159(1):107–114. doi: 10.1016/0002-9378(88)90502-9. [DOI] [PubMed] [Google Scholar]
- 28.Scholl T.O., Hediger M.L., Fischer R.L., Shearer J.W. Anemia versus iron deficiency: increased risk of preterm delivery. Am J Clin Nutr. 1992;55:985–988. doi: 10.1093/ajcn/55.5.985. [DOI] [PubMed] [Google Scholar]
- 29.Chopra J.S., Prabhakar S. Clinical features and risk factors in stroke in young. Acta Neurologica Scandivia. 1979;43:289–300. doi: 10.1111/j.1600-0404.1979.tb02984.x. [DOI] [PubMed] [Google Scholar]
- 30.Newman V., Judith T.F. Role of nutrition in the prevention of preeclampsia. Review of the literature. J Nurse Midwifery. 1990;35(5):282–291. doi: 10.1016/0091-2182(90)90081-F. [DOI] [PubMed] [Google Scholar]
- 31.Raman L., Pawashe A.B., Yasodhara P. Hyperferritinemia in pregnancy induced hypertension and eclampsia. J Postgrad Med. 1992;38(2):65–67. [PubMed] [Google Scholar]
- 32.Afkhami-Ardekani M, Rashidi M. Iron status in women with and without gestational diabetes mellitus. J Diabetes Complications 2008; 4 (Epub ahead of print). [DOI] [PubMed]
- 33.Lao T.T., Chan L.Y., Tam K.F., Ho L.F. Maternal hemoglobin and risk of gestational diabetes mellitus in Chinese women. Obs Gynaecol. 2002;99(5Pt1):807–812. doi: 10.1016/S0029-7844(02)01941-5. [DOI] [PubMed] [Google Scholar]
- 34.Coleman R.J. Comparison of plasma volume levels in normal pregnancy between two ethnic groups in Fiji. The Australian and New Zealand J Obs Gynaecol. 1978;18(2):127–132. doi: 10.1111/j.1479-828X.1978.tb00029.x. [DOI] [Google Scholar]
- 35.Koller O., Sandvei R., Sagen N. High hemoglobin levels during pregnancy and fetal risk. Int J Gynaecol Obs. 1980;18(1):53–56. doi: 10.1002/j.1879-3479.1980.tb00241.x. [DOI] [PubMed] [Google Scholar]
- 36.Pena-Rosas JP, Viteri FE. Effects of routine oral iron supplementation with or without folic acid for women during pregnancy. Cochrane Database of Systematic Reviews 2006; Issue 3. Art. No.: CD004736. DOI: 10.1002/14651858.CD004736. [DOI] [PubMed]
- 37.Steer P., Alam M.A., Wadsworth J., Welch A. Relation between maternal haemoglobin concentration and birth weight in different ethnic groups. BMJ. 1995;310(6978):489–491. doi: 10.1136/bmj.310.6978.489. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 38.Zhou L.M., Yang W.W., Hua J.Z., Deng C.Q., Tao X., Stoltzfus R.J. Relation of hemoglobin measured at different times in pregnancy to preterm birth and low birth weight in Shanghai. Am J Epidemiol. 1998;148(10):998–1006. doi: 10.1093/oxfordjournals.aje.a009577. [DOI] [PubMed] [Google Scholar]
- 39.Stephansson O., Dickman P., Johansson A., Cnattingius S. Maternal hemoglobin concentration during pregnancy and risk of stillbirth. JAMA. 2000;284(20):2611–2617. doi: 10.1001/jama.284.20.2611. [DOI] [PubMed] [Google Scholar]
- 40.Scholl T.O. High third-trimester ferritin concentration: associations with very preterm delivery, infection, and maternal nutritional status. Obs Gynaecol. 1998;92(2):162–166. doi: 10.1016/s0029-7844(98)00157-4. [DOI] [PubMed] [Google Scholar]
- 41.National Nutrition Monitoring bureau, Technical report No. 22, Prevalence of micronutrient deficiencies, National Institute of Nutrition- ICMR, 2003.
- 42.Toteja GS, Singh P, Dhillon BS, Saxena BN. Micronutrient deficiency disorders in 16 Distt. of India — ICMR Task Force Study in 13 States. 1997–99.
- 43.Shatrugna V., Raman L., Kailash U., Balakrishna N., Rao K.V. Effect of dose and formulation on iron tolerance in pregnancy. Natl Med J India. 1999;12(1):18–20. [PubMed] [Google Scholar]
- 44.Fields supplement trial in pregnant women with 60 mg, 120 mg and 180 mg of iron with 500mcg of folic acid-An ICMR task force study. Published 1992.
- 45.Mukhopadhyay A., Bhatla N., Kriplani A., Pandey R.M., Saxena R. Daily versus intermittent iron supplementation in pregnant women: Hematological and pregnancy outcome. J Obs Gynaecol Res. 2004;30(6):409–413. doi: 10.1111/j.1447-0756.2004.00223.x. [DOI] [PubMed] [Google Scholar]
- 46.Cogswell M.E., Parvanta I., Ickes L., Yip R., Brittenham G.M. Iron supplementation during pregnancy anemia, and birth weight: a randomized controlled trial. Am J Clin Nutr. 2003;78(4):773–781. doi: 10.1093/ajcn/78.4.773. [DOI] [PubMed] [Google Scholar]
- 47.Gambling L., Andersen H.S., Czopek A., Wojciak R., Krejpcio Z., McArdle H.J. Effect of timing of iron supplementation on maternal and neonatal growth and iron status of iron-deficient pregnant rats. J Physiol. 2004;561(1):195–203. doi: 10.1113/jphysiol.2004.068825. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 48.Galloway R., Judith M.G. Determinants of compliance with iron supplemtation: supplies, side effects, or psychology? Soc Sci Med. 1994;39(3):381–390. doi: 10.1016/0277-9536(94)90135-X. [DOI] [PubMed] [Google Scholar]
- 49.Chisholm M. A controlled clinical trial of prophylactic folic acid and iron in pregnancy. Br J Obs Gynae. 1966;73:191–196. [Google Scholar]
- 50.Svanberg B., Arvidsson B., Norrby A., Rybo G., Sölvell L., Svanberg B., Arvidsson B., et al. Absorption of supplemental iron during pregnancy-a longtitudinal study with repeated bone marrow studies and absorption measurements. Acru Obs Gyneacol Scand. 1975;48:87–108. doi: 10.3109/00016347509156332. [DOI] [PubMed] [Google Scholar]
- 51.Griffiths M. Concept testing nutrition communication and behaviour change components. Manoff International, Indinesia Nutrition Development program. 1980;1:38. [Google Scholar]
- 52.Blot I., Papiernik E., Kaltwasser J.P., Werner E., Tchernia G. Influence of routine administration of folic acid and iron during pregnancy. Gynecol Obs Invest. 1981;12(6):294–304. doi: 10.1159/000299659. [DOI] [PubMed] [Google Scholar]
- 53.Romslo I., Haram K., Sagen N., Augensen K. Iron requirement in normal pregnancy as assessed by serum ferritin, serum transferring saturation and erythrocyte protoporphyrin determinations. Br J Obs Gynaecol. 1983;90:101–107. doi: 10.1111/j.1471-0528.1983.tb08891.x. [DOI] [PubMed] [Google Scholar]
- 54.Charoenlarp P., Dhanamitta S., Kaewvichit R., Silprasert A., Suwanaradd C., Na-Nakorn S., et al. A WHO collaborative study on iron supplementation in Burma and Thailand. Am J Clin Nutr. 1988;47:280–297. doi: 10.1093/ajcn/47.2.280. [DOI] [PubMed] [Google Scholar]
- 55.Souza A.I., Batista F.M., Cardoso F.L., Natal F.J. The effectiveness of three regimens using ferrous sulfate to treat anemia in pregnant women. Rev Panam Salud Publica. 2004;15(5):313–319. doi: 10.1590/S1020-49892004000500005. [DOI] [PubMed] [Google Scholar]
- 56.Ekström E.C., Kavishe F.P., Habicht J.P., Frongillo E.A., Rasmussen K.M., Hemed L., et al. Adherence to iron supplementation during pregnancy in Tanzania: determinants and hematologic consequences. Am J Clin Nutr. 1996;64:368–374. doi: 10.1093/ajcn/64.3.368. [DOI] [PubMed] [Google Scholar]
- 57.ACC/SCN. Controlling iron deficiency. A report based on an ACC/SCN workshop, State-of-the-art series. Nutrition policy discussion paper no. 9 1991; p. 4.
- 58.Sood S.K., Ramachandran K., Rani K., Ramalingaswami V., Mathan V.I., Ponniah J., et al. W.H.O. sponsored collaborative studies on nutritional anaemia in India. 1. The effects of supplemental oral iron administration to pregnant women. Q J Med. 1975;44(174):241–258. [PubMed] [Google Scholar]
- 59.GOI- Government of India. Ministry of health and Family welfare, UNICEF/New Delhi, report of the meeting on the prevention and control of nutritional anemia 1989; pg34.
- 60.Mumtaz Z., Shahab S., Butt N., Rab M.A., DeMuynck A. Daily iron supplementation is more effective than twice weekly iron supplementation in pregnant women in Pakistan in a randomized double-blind clinical trial. J Nutr. 2000;130:2697–2702. doi: 10.1093/jn/130.11.2697. [DOI] [PubMed] [Google Scholar]
- 61.Hyder S.M.Z., Persson L.A., Chowdhury A.M.R., Ekström E.C. Do side-effects reduce compliance to iron supplementation? A study of daily- and weekly-dose regimens in pregnancy. J Health Popul Nutr. 2002;20(2):175–179. [PubMed] [Google Scholar]
- 62.Saha L., Pandhi P., Gopalan S., Malhotra S., Saha P.K. Comparison of efficacy, tolerability, and cost of iron polymaltose complex with ferrous sulphate in the treatment of iron deficiency anemia in pregnant women. Med Gen Med. 2007;9(1):1. [PMC free article] [PubMed] [Google Scholar]
- 63.Srigiridhar K., Nair K.M. Supplementation with alpha-tocopherol or a combination of alpha-tocopherol and ascorbic acid protects the gastrointestinal tract of iron-deficient rats against iron-induced oxidative damage during iron repletion. Br J Nutr. 2000;84:165–173. [PubMed] [Google Scholar]
- 64.Srigiridhar K., Nair K.M. Iron-deficient intestine is more susceptible to peroxidative damage during iron supplementation in rats. Free Radic Biol Med. 1998;25:660–665. doi: 10.1016/S0891-5849(98)00086-0. [DOI] [PubMed] [Google Scholar]
- 65.Srigiridhar K., Nair K.M., Subramanian R., Singotamu L. Oral repletion of iron induces free radical mediated alterations in the gastrointestinal tract of rat. Molecular and Cellular Biochemistry. 2001;219(1–2):91–98. doi: 10.1023/A:1011023111048. [DOI] [PubMed] [Google Scholar]
- 66.Viteri F.E. Iron supplementation for the control of iron deficiency in populations at risk. Nutr Rev. 1997;55:195–209. doi: 10.1111/j.1753-4887.1997.tb01607.x. [DOI] [PubMed] [Google Scholar]
- 67.Lund E.K., Wharf S.G., Fairweather-Tait S.J., Johnson I.T. Oral ferrous sulfate supplements increase the free radical-generating capacity of feces from healthy volunteers. Am J Clin Nutr. 2003;78(3):498. doi: 10.1093/ajcn/69.2.250. [DOI] [PubMed] [Google Scholar]
- 68.William B., Aharon R., Itzchak N.S., Ayala A., Chaim H.Z., Ioav C. The assessment of serum nontransferrin-bound iron in chelation therapy and iron supplementation. Blood. 2000;95:2975–2982. [PubMed] [Google Scholar]
- 69.Gambling L., Andersen H.S., Czopek A., Wojciak R., Krejpcio Z., McArdle H.J. Effect of timing of iron supplementation on maternal and neonatal pregnant rats. J Physiol. 2004;561(15):195–203. doi: 10.1113/jphysiol.2004.068825. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 70.Jansson L.T., Perkki M.V., Willis W.T., Refino C.J., Dallman P.R. Red cell superoxide dismutase is increased in iron deficiency anemia. Acta Haematol. 1985;74(4):218–221. doi: 10.1159/000206222. [DOI] [PubMed] [Google Scholar]
- 71.Chen Q., Le G.W., Shi Y.H., Zhang S.M., Jin X. Effect of iron supplementation on intestinal function and oxidative stress in piglets with induced colitis. J Animal Feed Sciences. 2007;16:205–213. [Google Scholar]
- 72.Acharya J., Punchard N.A., Taylor J.A., Thompson R.P., Pearson T.C. Red cell lipid peroxidation and antioxidant enzymes in iron deficiency. Eur J Haematol. 1991;47(4):287–291. doi: 10.1111/j.1600-0609.1991.tb01573.x. [DOI] [PubMed] [Google Scholar]
- 73.Ramachandran M., Iyer G.Y., Ramachandran M., Iyer G.Y. Erythrocyte glutathione reductase in iron deficiency anaemia. Clin Chim Acta. 1974;52(2):225–229. doi: 10.1016/0009-8981(74)90214-9. [DOI] [PubMed] [Google Scholar]
- 74.Sundaram R.C., Selvaraj N., Vijayan G., Bobby Z., Hamide A., Dasse N.R. Increased plasma malondialdehyde and fructosamine in iron deficiency anemia: Effect of treatment. Biomedicine & Pharmacotherapy. 2007;61(10):682–685. doi: 10.1016/j.biopha.2007.06.013. [DOI] [PubMed] [Google Scholar]
- 75.Isler M., Delibas N., Guclu M., Gultekin F., Sutcu R., Bahceci M., et al. Superoxide dismutase and glutathione peroxidase in erythrocytes of patients with iron deficiency anemia: effects of different treatment modalities. Croat Med J. 2002;43(1):16–19. [PubMed] [Google Scholar]
- 76.Ferreira A.L.A., Machado P.E.A., Matsubara L.S. Lipid peroxidation, antioxidant enzymes and glutathione levels in human erythrocytes exposed to colloidal iron hydroxide in vitro. Braz J Med Biol Res. 1999;32(6):689–694. doi: 10.1590/S0100-879X1999000600004. [DOI] [PubMed] [Google Scholar]
- 77.Sevgi Y., Gönenç C., Ciðdem A. Neutrophil glutathione peroxidase activity in iron deficiency anaemia. Scand J Haematol. 1986;36(1):58–60. doi: 10.1111/j.1600-0609.1986.tb02650.x. [DOI] [PubMed] [Google Scholar]
- 78.Olivares M., Araya M., Pizarro F., Letelier A. Erythrocyte Cu-Zn superoxide dismutase activity is decreased in iron-deficiency anemia. Biological Trace Element Research. 2006;112(3):193–203. doi: 10.1385/BTER:112:3:213. [DOI] [PubMed] [Google Scholar]
- 79.Binkoski A.E., Kris-Etherton P.M., Beard J.L. Iron Supplementation Does Not Affect the Susceptibility of LDL to Oxidative Modification in Women with Low Iron Status. J Nutr. 2004;134:99–103. doi: 10.1093/jn/134.1.99. [DOI] [PubMed] [Google Scholar]
- 80.Kumerova A., Lece A., Skesters A., Silova A., Petuhovs V. Anaemia and antioxidant defense of the red blood cells. Mater Med Pol. 1998;30(1–2):12–15. [PubMed] [Google Scholar]
- 81.Rehman A., Collis C.S., Yang M., Kelly M., Diplock A.T., Halliwell B., et al. The Effects of iron and vitamin C co-supplementation on oxidative damage to DNA in healthy volunteers. Biochemical and Biophysical Research Communications. 1998;246(1):293–298. doi: 10.1006/bbrc.1998.8592. [DOI] [PubMed] [Google Scholar]
- 82.Yang M., Collis C.S., Kelly M., Diplock A.T., Evans C.R. Do iron and vitamin C co-supplementation influence platelet function or LDL oxidizability in healthy volunteers? Eur J Clin Nutr. 1999;53(5):367–374. doi: 10.1038/sj.ejcn.1600730. [DOI] [PubMed] [Google Scholar]
- 83.Troost F.J., Saris W.H., Haenen G.R., Bast A., Brummer R.J. New method to study oxidative damage and antioxidants in the human small bowel: effects of iron application. Am J Physiol Gastrointest Liver Physiol. 2003;285:G354–G359. doi: 10.1152/ajpgi.00422.2002. [DOI] [PubMed] [Google Scholar]
- 84.Devrim E., Tarhan I., Ergüder I.B., Durak I. Oxidant/Antioxidant Status of Placenta, Blood, and Cord Blood Samples From Pregnant Women Supplemented With Iron. Journal of the Society for Gynecologic Investigation. 2006;13(7):502–505. doi: 10.1016/j.jsgi.2006.07.004. [DOI] [PubMed] [Google Scholar]
- 85.Yip R., Mohandas N., Clark M.R., Jain S., Shohet S.B., Dallman P.R. Red cell membrane stiffness in iron deficiency. Blood. 1983;62(1):99–106. [PubMed] [Google Scholar]
- 86.Petukhov V.I., Kumerova A.O., Letse A.G., Silova A.A., Shkesters A.P., Krishchuna M.A., et al. Erythremia: the activity of erythrocyte antioxidant enzymes and the association with iron deficiency. Ter Arkh. 1997;69(4):57–61. [PubMed] [Google Scholar]
- 87.Vives Corrons J.L., Miguel-García A., Pujades M.A., Miguel-Sosa A., Cambiazzo S., Linares M., et al. Increased susceptibility of microcytic red blood cells to in vitro oxidative stress. Eur J Haematol. 1995;55(5):327–331. doi: 10.1111/j.1600-0609.1995.tb00705.x. [DOI] [PubMed] [Google Scholar]
- 88.Avissar N., Farkash Y., Shaklai M. Erythrocyte enzymes in polycythemia vera: a comparison to erythrocyte enzyme activities of patients with iron deficiency anemia. Acta Haematol. 1986;76(1):37–43. doi: 10.1159/000206016. [DOI] [PubMed] [Google Scholar]
- 89.Riazantsev V.V., Grishchenko O.V., Pereira A.A., Belous A.M. Intensity of lipid peroxidation processes and activity of antioxidant enzymes in erythrocytes during anemia in pregnancy. Ukr Biokhim Zh. 1996;68(3):116–120. [PubMed] [Google Scholar]
- 90.Panchenko L.F., Lamchingiin T., Gerasimov A.M., Sukhanov I.S., Konoplina L.A. Superoxide dismutase activity in the blood of children with iron deficiency anemia. Vopr Med Khim. 1979;25(2):181–185. [PubMed] [Google Scholar]
- 91.Cellerino R., Guidi G., Perona G. Plasma iron and erythrocytic glutathione peroxidase activity. A possible mechanism for oxidative hemolysis in iron deficiency anemia. Scand J Haematol. 1976;17(2):111–116. [PubMed] [Google Scholar]
- 92.Mehmet A., Mehmet H., Abdurrahim K., Saadet O., Hakim C., Metin C. Lymphocyte DNA damage and oxidative stress in patients with iron deficiency anemia. Mutation research. Fundamental and molecular mechanisms of mutagenesis. 2006;601(2):144–149. doi: 10.1016/j.mrfmmm.2006.06.013. [DOI] [PubMed] [Google Scholar]
- 93.Golovin A.A., Konvai V.D. Lipid peroxidation in patients with iron deficiency anemia complicated by frequent acute respiratory diseases. Klin Med (Mosk) 1991;69(11):73–75. [PubMed] [Google Scholar]
- 94.Krause A., Baerwald C., Goebel K.M. Red cell metabolism and ferritin levels in iron deficiency anaemia. Biomed Biochim Acta. 1987;46(2–3):S218–S222. [PubMed] [Google Scholar]
- 95.Jain S.K., Yip R., Hoesch R.M., Pramanik A.K., Dallman P.R., Shohet S.B. Evidence of peroxidative damage to the erythrocyte membrane in iron deficiency. Am J Clin Nutr. 1983;37(1):26–30. doi: 10.1093/ajcn/37.1.26. [DOI] [PubMed] [Google Scholar]
- 96.Rao J., Jagadeesan V. Lipid peroxidation and activities of antioxidant enzymes in iron deficiency and effect of carcinogen feeding. Free Radic Biol Med. 1996;21(1):103–108. doi: 10.1016/0891-5849(95)02212-0. [DOI] [PubMed] [Google Scholar]
- 97.Srigiridhar K., Nair K.M. Protective effects of antioxidant enzymes and GSH in vivo on iron mediated lipid peroxidation in gastrointestinal tract of rat. Ind J Biochem Biophys. 1997;34(4):402–405. [PubMed] [Google Scholar]
- 98.Vir P., Kaur J., Mahmood A. Effect of Chronic Iron Ingestion on the Development of Brush Border Enzymes in Rat Intestine. Toxicology Mechanisms and Methods. 2007;17(7):393–399. doi: 10.1080/15376510601102793. [DOI] [PubMed] [Google Scholar]
- 99.Reveiz L, Gyte GM, Cuervo LG. Treatments for iron-deficiency anemia in pregnancy. Cochrane Database Syst Rev 2007; 18(2): CD003094. [DOI] [PubMed]
- 100.Beard J.L. Effectiveness and strategies of iron supplementation during pregnancy. Am J Clin Nutr. 2000;71(5):1288S–1294s. doi: 10.1093/ajcn/71.5.1288s. [DOI] [PubMed] [Google Scholar]