Iron Absorption and Transfer to the Fetus During Pregnancy in Normal Weight and Overweight/Obese Women and the Effects on Infants Iron Status (PIANO)
21 de abril de 2021 actualizado por: Isabelle Herter-Aeberli, Swiss Federal Institute of Technology
Maternal Iron Absorption and Utilization and Iron Transfer to the Fetus During Pregnancy in Normal Weight and Overweight/Obese Women and the Effects on Infant Iron Status
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.
Descripción general del estudio
Estado
Terminado
Condiciones
Descripción detallada
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.
Tipo de estudio
Intervencionista
Inscripción (Actual)
83
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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Zurich, Suiza, 8092
- Human Nutrition Laboratory ETH Zurich
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años a 45 años (Adulto)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Femenino
Descripción
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
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Ciencia básica
- Asignación: No aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Experimental: Isotopically labeled test meal week of pregnancy 20
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test meal labeled with 12 mg 57Fe
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Experimental: Isotopically labeled test meal week of pregnancy 30
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test meal labeled with 12 mg 58Fe
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Fractional iron absorption
Periodo de tiempo: week 20 of pregnancy
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The fractional iron absorption from the first test meal will be calculated based on the shift of the iron isotopic ratios in the collected blood samples 14 days after administration of the isotopically labeled meal.
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week 20 of pregnancy
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iron transfer from the mother to the fetus in cord blood/infant
Periodo de tiempo: delivery
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To determine the amount of iron transferred from the mother to the fetus
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delivery
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Fractional iron absorption
Periodo de tiempo: week 30 of pregnancy
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The fractional iron absorption from the second test meal will be calculated based on the shift of the iron isotopic ratios in the collected blood samples 14 days after administration of the isotopically labeled meal.
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week 30 of pregnancy
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infants iron status
Periodo de tiempo: over the first six months of life
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infants iron status
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over the first six months of life
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change in plasma ferritin
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in plasma ferritin
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in Hepcidin
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in Hepcidin
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in transferrin receptor
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in transferrin receptor
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in hemoglobin
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in hemoglobin
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in c-reactive protein
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in c-reactive protein
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in interleukin-6
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in interleukin-6
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Chage in alpha-1-acid glycoprotein
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Chage in alpha-1-acid glycoprotein
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in retinol binding protein
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in retinol binding protein
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in riboflavin
Periodo de tiempo: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Change in riboflavin
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weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
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Assessment of children's iron needs within their first 2 years of life using an isotope dilution technique
Periodo de tiempo: Follow-up blood samples at 3, 6, 12, 18, 24 months after birth
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Assessment of children's iron needs within their first 2 years of life
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Follow-up blood samples at 3, 6, 12, 18, 24 months after birth
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Assessment of recovery of mother's iron Status after pregnancy using an isotope dilution technique
Periodo de tiempo: Follow-up blood samples at 3, 6, 12, 18, 24 months after delivery
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Assessment of recovery of mother's iron Status after pregnancy
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Follow-up blood samples at 3, 6, 12, 18, 24 months after delivery
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infants iron status
Periodo de tiempo: over the first 24 months of life
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infants iron status
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over the first 24 months of life
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Colaboradores e Investigadores
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Patrocinador
Publicaciones y enlaces útiles
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Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
1 de febrero de 2016
Finalización primaria (Actual)
1 de abril de 2019
Finalización del estudio (Actual)
1 de septiembre de 2020
Fechas de registro del estudio
Enviado por primera vez
8 de enero de 2016
Primero enviado que cumplió con los criterios de control de calidad
18 de abril de 2016
Publicado por primera vez (Estimar)
21 de abril de 2016
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
23 de abril de 2021
Última actualización enviada que cumplió con los criterios de control de calidad
21 de abril de 2021
Última verificación
1 de abril de 2021
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- PIANO
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