Statut martial et échanges Fœto-Maternels de Fer

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.