Comparison of serum levels of iron, zinc and copper in anaemic and non-anaemic pregnant women in China.

Zinc and copper deficiency is associated with anaemia or iron deficiency and affects fetus growth and pregnant women during pregnancy. To examine iron, zinc and copper status of Chinese pregnant women with and without anaemia in the third trimester, 1185 subjects were enrolled for measurements of Hb, ferritin, transferrin, soluble transferrin receptor (sTfR), and serum iron, zinc and copper. The results showed that there were lower levels of ferritin (14.1 microg/L) and transferrin (3.33 g/L) in subjects with Hbor=101 g/L. sTfR levels in subjects with Hbor=120 g/L (38.5 nmol/L vs. 25.04 nmol/L, P<0.001). Serum iron was lower in subjects with Hbor=120 g/L (871 microg/L vs. 990 microg/L, P<0.01). Lower levels of serum iron and zinc were also found in anaemic (Hb<110 g/L) as compared with non-anaemic women (Hb>or=110 g/L). Frequencies of marginal deficiencies in serum iron and zinc were 41.58% and 51.05% respectively higher in anaemic than in non-anaemic subjects. Distribution of serum zinc and iron showed a decreasing trend as Hb decreased. Few anaemic as well as non-anaemic subjects had copper deficiency although copper and Hb levels were found inversely correlated and the ratio of copper/iron was higher in anaemic than in non-anaemic group. In conclusion, a lower level of serum zinc in anaemic pregnant women might be related to anaemia and iron deficiency during pregnancy. Therefore, combined zinc and iron supplementation should be recommended to Chinese pregnant women, especially those with anaemia.

The multiple vitamin status of Chinese pregnant women with anemia and nonanemia in the last trimester.

Iron-deficiency or anemia in pregnancy is a major public health problem in China. This cross-sectional study was carried out to observe the association between iron status and multiple vitamin levels of Chinese pregnant women in the third trimester. We measured iron, ascorbic acid, retinol, folate and vitamin B12 in serum, and riboflavin in urine specimens of 1,163 pregnant women in four sites throughout rural and city areas in China. Based on hemoglobin concentrations (Hb), the subjects were divided into an anemia group with Hb < 110 g/L or Hb < or = 100 g/L as severe anemia group, and nonanemia group with Hb > or = 110 g/L. Results showed that 41.58% of the population with serum iron < 700 microg/L and 51.04% of the population with ferritin < 12 microg/L in the anemia group, percentages that were much higher than those in the nonanemia group. Relationships between five vitamins and hemoglobin concentrations of all subjects were observed. There was a lower level of serum ascorbic acid (291.05 microg/dL) in the Hb < or = 100 g/L group than in the Hb > or = 120 g/L group (487.79 microg/dL) (p < 0.001). Serum levels of vitamin B12 and folate were 445.67 pg/mL and 5.94 ng/mL in the Hb < or = 100 g/L group, whose levels were much lower than the levels of 502.01 pg/mL (p < 0.012) and 8.07 ng/mL (p < 0.010) respectively in the Hb > or = 120 g/L group. Further, cross-sectional analysis showed positive correlations between abnormal hematological results and prevalences of vitamin deficiencies. The subjects with iron-deficiency anemia had much higher rates of vitamin C, folate and vitamin B12 deficiencies than those in the nonanemic subjects, and especially in the deficient rates of ascorbic acid and folate in the anemia (Hb < 110 g/L) group, which reached 64.04% and 22.70% respectively. Moreover, we observed that the decreasing trends of hemoglobin concentrations were accompanied by the decreases of serum levels of vitamin A, ascorbic acid, folate and vitamin B12. In conclusion, multiple vitamin deficiencies, especially ascorbic acid, retinol and folic acid, may be associated with anemia or iron deficiency in pregnant women in the last trimester. The study suggested that anemic pregnant women in China should be supplemented with iron and multiple vitamins simultaneously.