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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. april 2021 oppdatert av: 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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Faktiske)

83

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Sveits
      • Zurich, Sveits, 8092
        • Human Nutrition Laboratory ETH Zurich

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 45 år (Voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Hunn

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Grunnvitenskap
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Isotopically labeled test meal week of pregnancy 20
Annen: Stable iron isotope 57 (57Fe) labeled iron solution
test meal labeled with 12 mg 57Fe
Eksperimentell: Isotopically labeled test meal week of pregnancy 30
Annen: Stable iron isotope 58 (58Fe) labeled iron solution
test meal labeled with 12 mg 58Fe

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Fractional iron absorption
Tidsramme: week 20 of pregnancy
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.
week 20 of pregnancy
iron transfer from the mother to the fetus in cord blood/infant
Tidsramme: delivery
To determine the amount of iron transferred from the mother to the fetus
delivery
Fractional iron absorption
Tidsramme: week 30 of pregnancy
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.
week 30 of pregnancy
infants iron status
Tidsramme: over the first six months of life
infants iron status
over the first six months of life

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in plasma ferritin
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in plasma ferritin
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in Hepcidin
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in Hepcidin
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in transferrin receptor
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in transferrin receptor
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in hemoglobin
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in hemoglobin
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in c-reactive protein
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in c-reactive protein
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in interleukin-6
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in interleukin-6
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Chage in alpha-1-acid glycoprotein
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Chage in alpha-1-acid glycoprotein
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in retinol binding protein
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in retinol binding protein
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in riboflavin
Tidsramme: weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Change in riboflavin
weeks of pregnancy 12, 18, 20, 28, 30, 36; 3 and 6 months after delivery
Assessment of children's iron needs within their first 2 years of life using an isotope dilution technique
Tidsramme: Follow-up blood samples at 3, 6, 12, 18, 24 months after birth
Assessment of children's iron needs within their first 2 years of life
Follow-up blood samples at 3, 6, 12, 18, 24 months after birth
Assessment of recovery of mother's iron Status after pregnancy using an isotope dilution technique
Tidsramme: Follow-up blood samples at 3, 6, 12, 18, 24 months after delivery
Assessment of recovery of mother's iron Status after pregnancy
Follow-up blood samples at 3, 6, 12, 18, 24 months after delivery
infants iron status
Tidsramme: over the first 24 months of life
infants iron status
over the first 24 months of life

Samarbeidspartnere og etterforskere

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Sponsor

Swiss Federal Institute of Technology

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. februar 2016

Primær fullføring (Faktiske)

1. april 2019

Studiet fullført (Faktiske)

1. september 2020

Datoer for studieregistrering

Først innsendt

8. januar 2016

Først innsendt som oppfylte QC-kriteriene

18. april 2016

Først lagt ut (Anslag)

21. april 2016

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

23. april 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

21. april 2021

Sist bekreftet

1. april 2021

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • PIANO

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