UTJECAJ VRIJEDNOSTI SERUMSKOG ŽELJEZA TOKOM TRUDNOĆE NA POROĐAJNU TEŽINU NOVOROĐENČADI
THE INFLUENCE OF SERUM IRON VALUES DURING PREGNANCY ON THE BIRTH WEIGHT OF NEWBORNS

Summary/Abstract: Since many women enter pregnancy with low iron stores, they are often at increased risk of developing anemia. During pregnancy, iron levels must significantly rise to support fetoplacental development and the mother's adaptation to pregnancy. Today, additional iron intake is recommended through supplements of 30-40 mg per day, from the 20th week of pregnancy until delivery, to build iron stores and maintain hemoglobin concentration. Routine iron supplementation from the beginning of pregnancy in women with adequate iron stores and no anemia is not rational and may be potentially harmful. It is crucial to tailor prenatal iron supplementation to the needs of each pregnant woman, adjusting it according to baseline hemoglobin levels to achieve optimal fetal development, as excessive iron doses appear to negatively affect fetal growth. Objectives: The aim of this study was to determine the impact of serum iron levels during pregnancy on the birth weight of newborns. Methods: In a retrospective study, we analyzed 548 pregnancies with recorded serum iron levels in pregnant women and birth weight of neonates at the Maternity Department of the Health Center in Cazin, between 2022 and 2024. Serum iron levels were categorized into three groups. The first group included pregnant women with serum iron levels <8 (μmol/L), the second group consisted of pregnant women with serum iron levels between 8-30 (μmol/L), and the third group included pregnant women with serum iron levels >30 (μmol/L). For each pregnant woman, we correlated the corresponding serum iron level with the birth weight of the neonate and conducted a descriptive analysis of the data. Results and Discussion: Analyzing the data, we found that 18.2% of pregnant women had serum iron levels below 8 μmol/L, while 80.1% had serum iron levels between 8-30 μmol/L, and 1.7% had serum iron levels above 30 μmol/L. Among pregnant women with serum iron levels below 8 μmol/L, higher arithmetic means and standard deviations of neonatal birth weights were observed (Mean±SD 3462±506.21g) compared to those with serum iron levels between 8-30 μmol/L (Mean±SD 3432±406.77g) and those with levels above 30 μmol/L (Mean±SD 3418±337.39g). Neonatal birth weights in pregnant women with serum iron levels below 8 μmol/L were 30 to 40 g higher than those in women with serum iron levels between 8-30 μmol/L and above 30 μmol/L, but the difference was not statistically significant (*p=0.811). Iron supplementation during pregnancy may improve pregnancy outcomes when the mother has an iron deficiency; however, prophylactic supplementation may increase the risk when the mother does not have an iron deficiency. Conclusions: Although the importance of iron for maternal health and fetal development during pregnancy is well-researched, there are significant gaps in our understanding of iron regulation during pregnancy. It is crucial to adjust prenatal iron supplementation to the needs of each pregnant woman, specifically by tailoring it to the initial hemoglobin levels in order to achieve optimal fetal development, as excessive iron doses seem to adversely affect fetal growth. Recommendations: Future directions include defining the role and regulation of maternal and fetal hepcidin, clarifying the mechanisms and regulation of placental iron transport, and understanding how iron supplementation influences these processes in both healthy and complicated pregnancies.

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