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Article

Prenatal Iron Supplements Impair Zinc Absorption in Pregnant Peruvian Women^{1 ,2}

Kimberly O. O’Brien^*3, Nelly Zavaleta^**, Laura E. Caulfield^*, Jianping Wen and Steven A. Abrams

^* The Johns Hopkins School of Hygiene and Public Health, Division of Human Nutrition Baltimore, MD 21205, ^** The Instituto de Investigacion Nutricional, Lima, Peru, and The U.S. Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030

³To whom correspondence should be addressed.

Prenatal iron supplements may adversely influence zinc absorption during pregnancy. To examine the impact of prenatal iron supplements on supplemental zinc absorption, fractional zinc absorption was measured in 47 pregnant Peruvian women during the third trimester of pregnancy (33 ± 1 wk gestation). Of these 47 women, 30 received daily prenatal supplements from wk 10–24 of pregnancy until delivery. Supplements contained 60 mg of Fe and 250 µg of folate without [iron group (Fe), n = 16] or with [iron and zinc supplemented group (Fe + Zn), n = 14] 15 mg of Zn. The remaining 17 women [unsupplemented control group (C)] received no prenatal supplementation. Zinc concentrations were measured in plasma, urine and cord blood and percentage zinc absorption was determined following dosing with oral (⁶⁷Zn) and intravenous (⁷⁰Zn) stable zinc isotopes. Percentage zinc absorption was significantly lower than controls in fasting women receiving iron- containing prenatal supplements (20.5 ± 6.4 vs. 20.2 ± 4.6 vs. 47.0 ± 12.6%, Fe, Fe + Zn and C groups, respectively, P < 0.0001, n = 40). Plasma zinc concentrations were also significantly lower in the Fe group compared to the C group (8.2 ± 2.2 vs. 9.2 ± 2.2 vs. 10.9 ± 1.8 µmol/L, Fe, Fe + Zn and C groups, respectively, P = 0.002), and cord zinc concentrations were significantly related to maternal plasma Zn levels (y = 6.383 + 0.555x, r = 0.486, P = 0.002). The inclusion of zinc in prenatal supplements may reduce the potential for iron supplements to adversely influence zinc status in populations at risk for deficiency of both these nutrients.

KEY WORDS: • stable isotopes • zinc • pregnancy • iron • Peru • absorption • women

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