Iron Metabolism in African American Women in the Second and Third Trimesters of High-Risk Pregnancies

Objective To examine iron metabolism during the second and third trimesters in African American women with high-risk pregnancies. Design Longitudinal pilot study. Setting Large, university-based, urban Midwestern U.S. medical center. Participants Convenience sample of 32 African American women with high-risk pregnancies seeking care at an urban maternal–fetal medicine clinic. Methods Nonfasting venous blood was collected in the second and third trimesters to assess iron status, hepcidin, and systemic inflammation. Anthropometric and survey data were obtained via self-report. Descriptive statistics were calculated from these data, and changes in the clinical parameters between the second and third trimesters were evaluated via paired t tests. Associations among demographic, reproductive, anthropometric, inflammatory, and iron-related parameters were also assessed in each trimester. Results The mean age of participants was 28.3 (± 6.8) years, and mean prepregnancy body mass index was 31.9 (± 10.7) kg/m². In the longitudinal analysis, significant (p <.05) declines in serum iron, ferritin, transferrin saturation, and C-reactive protein were observed between the second and third trimesters. There was no statistically significant change in hepcidin between trimesters. When using a ferritin level cut-point of less than 15 ng/ml and soluble transferrin receptor level of greater than 28.1 nmol/L, 48% of the participants (14 of 29) were classified with iron deficiency in the third trimester. Conclusion In this pilot study, iron deficiency was prevalent among a small cohort of African American women with high-risk pregnancies. Hepcidin concentrations were greater than previously reported in healthy, pregnant, primarily White women, which suggests decreased iron bioavailability in this high-risk group.