Abstract:
The present study deals with the in vivo study in humans of trans-placental and veino-arterial
umbilical iron exchanges in order to understand fetal-maternal iron transfer, taking into account the
martial status and to specify the possible relations between maternal, placental and fetal iron
statuses.
A total of 97 mothers, with normal term pregnancy with no pathology that could interfere with
iron metabolism programmed to deliver by prophylactic caesarean section in Tébessa, were
included in the study. General and anthropometric characteristics, gestations and health status were
noted. Martial status, hemoglobin (Hb), hematocrit (Hct), serum iron, total transferrin iron binding
(CTF), and serum ferritin parameters were measured in the blood of the antecubital vein (Va) and
vein (Vo) and umbilical artery (Ao). Iron intake during the last month of gestation was estimated.
The overall characteristics of our maternal and newborn population were considered normal and
the adopted study protocol met our objectives.
Trans-placental transfers of Hb, iron and ferritin were performed against Vo-Va concentration
gradient, respectively, 4.17 ± 2.01 g /dl, 58.36 ± 30.85 μg /dl and 97.03 ± 59.87 ng/ml.
A positive relationship indicates that placental Hb is 28% of that of the mother (r = 0.22, P =
0.02), 60% of maternal serum iron is transferred to the placenta (r = 0.39 P <0.0001). Placental
ferritin iron storage appears to be independent of maternal ferritin.
In the fetal blood (Ao), the iron status parameter concentrations were significantly higher than
those of the mothers. The significant relationships highlighted, indicate that in addition to the basal
concentration (91.35 μg / dl), 48% of maternal iron is transferred to the fetus (r = 0.26, P = 0.005);
and that in addition to the base 12 g / dl, fetal Hb represents 27% of that of the mother (r = 0.22, P =
0.02). These links became obvious only if maternal martial status is uncompromised. The fetal
balance (Vo - Ao) of iron status is always balanced.
Concentration of maternal Hb and Hct and active transfer of Hb by placental enrichment
influence fetal growth (weight, height and head circumference). The size of neonates is correlated
with serum iron and the saturation factor of placental transferrin.
In addition to the basal concentration, 84% of the non-haem iron supply is provided to the fetus,
whereas the heme iron, beyond the threshold limit (48% of maternal iron), is no longer involved in
this transfer.
